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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $302.00 | Professional | None | $257.04 | $269.15 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $549.54 Typical High $588.84 | Facility | None | $436.52 | $549.54 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $549.54 | Professional | None | $251.19 | $263.03 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $37.15 | Professional | RR · Rental | $25.12 | $25.12 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | UE · Used equipment | $190.55 | $190.55 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $630.96 | Facility | None | $616.60 | $616.60 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $549.54 | Facility | None | $316.23 | $316.23 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $2,344.23 | Professional | None | $229.09 | $316.23 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $831.76 Median $1,659.59 Typical High $2,187.76 | Facility | None | $831.76 | $1,659.59 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $776.25 | Professional | None | $346.74 | $457.09 | $776.25 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
United Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $398.11 | Professional | None | $138.04 | $263.03 | $398.11 |
5 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 $128.82 Median $134.90 Typical High $147.91 | Professional | 52 · Reduced service | $128.82 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $51.29 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $44.67 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $29.51 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | KX · Policy requirements met | $354.81 | $354.81 | $354.81 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 28th of 51
$269
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.