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 $281.84 Median $281.84 Typical High $537.03 | Facility | None | $281.84 | $281.84 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $562.34 | Facility | None | $269.15 | $416.87 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $338.84 | Professional | None | $269.15 | $281.84 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $512.86 | Facility | None | $257.04 | $389.05 | $512.86 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $691.83 Typical High $776.25 | Facility | None | $338.84 | $691.83 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $354.81 | Professional | None | $281.84 | $281.84 | $354.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $239.88 Median $537.03 Typical High $912.01 | Facility | None | $239.88 | $537.03 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $389.05 | Professional | None | $186.21 | $251.19 | $389.05 |
United Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | None | $269.15 | $269.15 | $302.00 |
4 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 $138.04 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
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· 35th of 51
$282
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.