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 $1,258.93 Median $1,258.93 Typical High $2,570.40 | Facility | None | $1,258.93 | $1,258.93 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $2,570.40 | Facility | None | $1,258.93 | $1,905.46 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,258.93 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,630.27 | Facility | None | $1,318.26 | $1,995.26 | $2,630.27 |
CareSource Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,090.30 Typical High $3,467.37 | Facility | None | $1,737.80 | $3,090.30 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,258.93 | $1,698.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $4,073.80 | Facility | None | $1,445.44 | $2,630.27 | $4,073.80 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $524.81 Median $1,380.38 Typical High $2,290.87 | Professional | None | $524.81 | $1,380.38 | $2,290.87 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,258.93 | $1,659.59 |
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 $616.60 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $616.60 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
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· 30th of 51
$1,259
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.