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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | None | $79.43 | $81.28 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $501.19 | Facility | None | $125.89 | $181.97 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $117.49 | Professional | None | $79.43 | $79.43 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $120.23 Typical High $158.49 | Facility | None | $79.43 | $120.23 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $346.74 Typical High $346.74 | Facility | None | $144.54 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $588.84 | Professional | None | $79.43 | $125.89 | $588.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $234.42 Median $912.01 Typical High $2,137.96 | Facility | None | $234.42 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $125.89 Median $245.47 Typical High $1,000.00 | Professional | None | $125.89 | $245.47 | $1,000.00 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $218.78 | Professional | None | $125.89 | $125.89 | $218.78 |
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 $39.81 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $39.81 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $8.13 |
Where Indiana sits
The same service costs 7.2 times more in Hawaii than in Kentucky. 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· 49th of 51
$81.28
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.