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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $181.97 | Professional | None | $131.83 | $134.90 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $288.40 | Facility | None | $181.97 | $229.09 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $363.08 | Professional | None | $229.09 | $269.15 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $26.92 Typical High $38.02 | Professional | RR · Rental | $23.99 | $26.92 | $38.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $199.53 Typical High $288.40 | Professional | UE · Used equipment | $177.83 | $199.53 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $389.05 | Facility | None | $380.19 | $380.19 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $295.12 | Facility | None | $229.09 | $275.42 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $1,202.26 | Professional | None | $204.17 | $275.42 | $1,202.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $346.74 Median $724.44 Typical High $2,187.76 | Facility | None | $346.74 | $724.44 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $346.74 | Professional | None | $162.18 | $223.87 | $346.74 |
United Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $323.59 | Professional | None | $123.03 | $208.93 | $323.59 |
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 $66.07 Median $67.61 Typical High $91.20 | Professional | 52 · Reduced service | $66.07 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $36.31 | Professional | 53 · Discontinued | $26.30 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $27.54 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $18.20 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 10th of 51
$257
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.