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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | None | $316.23 | $316.23 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $660.69 Typical High $691.83 | Facility | None | $512.86 | $660.69 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $660.69 | Professional | None | $338.84 | $338.84 | $660.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | RR · Rental | $33.88 | $33.88 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | UE · Used equipment | $257.04 | $257.04 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $954.99 | Facility | None | $912.01 | $912.01 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $660.69 | Facility | None | $416.87 | $416.87 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $3,090.30 | Professional | None | $309.03 | $416.87 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $794.33 | Professional | None | $407.38 | $537.03 | $794.33 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Facility | None | $363.08 | $363.08 | $371.54 |
United Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $467.74 | Professional | None | $186.21 | $316.23 | $467.74 |
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 $158.49 Median $158.49 Typical High $223.87 | Professional | 52 · Reduced service | $158.49 | $158.49 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | 53 · Discontinued | $63.10 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $66.07 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $44.67 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $44.67 |
Where Indiana sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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· 37th of 51
$339
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.