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 $331.13 Median $331.13 Typical High $645.65 | Facility | None | $331.13 | $331.13 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $489.78 Typical High $660.69 | Facility | None | $323.59 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $398.11 | Professional | None | $323.59 | $331.13 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $478.63 Typical High $630.96 | Facility | None | $316.23 | $478.63 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $912.01 | Facility | None | $323.59 | $323.59 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $416.87 | Professional | None | $331.13 | $331.13 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $331.13 Median $912.01 Typical High $2,089.30 | Facility | None | $331.13 | $912.01 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $331.13 | Professional | None | $239.88 | $302.00 | $331.13 |
United Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | None | $323.59 | $323.59 | $363.08 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
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· 34th of 51
$331
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.