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 $151.36 Median $199.53 Typical High $275.42 | Facility | None | $151.36 | $199.53 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $288.40 | Facility | None | $138.04 | $213.80 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $169.82 | Professional | None | $138.04 | $144.54 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $275.42 | Facility | None | $138.04 | $204.17 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $363.08 Typical High $398.11 | Facility | None | $177.83 | $363.08 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | None | $144.54 | $144.54 | $181.97 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $138.04 Median $275.42 Typical High $912.01 | Facility | None | $138.04 | $275.42 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $245.47 | Professional | None | $107.15 | $131.83 | $245.47 |
United Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | None | $138.04 | $138.04 | $154.88 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
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· 17th of 51
$145
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.