How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $331.13 | Facility | None | $173.78 | $173.78 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $257.04 Typical High $346.74 | Facility | None | $162.18 | $257.04 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $208.93 | Professional | None | $162.18 | $173.78 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $331.13 | Facility | None | $165.96 | $245.47 | $331.13 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $436.52 Typical High $478.63 | Facility | None | $213.80 | $436.52 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $218.78 | Professional | None | $173.78 | $173.78 | $218.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $158.49 Median $331.13 Typical High $524.81 | Facility | None | $158.49 | $331.13 | $524.81 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $245.47 | Professional | None | $120.23 | $151.36 | $245.47 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | None | $162.18 | $162.18 | $181.97 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 54 · Surgery only | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $25.70 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.38 |
Where Indiana sits
Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 40th of 51
$174
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.