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 $229.09 Median $229.09 Typical High $446.68 | Facility | None | $229.09 | $229.09 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $457.09 | Facility | None | $223.87 | $338.84 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $281.84 | Professional | None | $223.87 | $229.09 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $436.52 | Facility | None | $218.78 | $323.59 | $436.52 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $616.60 Typical High $616.60 | Facility | None | $316.23 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | None | $229.09 | $229.09 | $288.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $218.78 Median $660.69 Typical High $2,089.30 | Facility | None | $218.78 | $660.69 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $245.47 | Professional | None | $162.18 | $204.17 | $245.47 |
United Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | None | $223.87 | $223.87 | $245.47 |
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 $112.20 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $112.20 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $33.88 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
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· 42nd of 51
$229
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.