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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $263.03 | Professional | None | $154.88 | $162.18 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $616.60 | Professional | None | $309.03 | $309.03 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $269.15 Typical High $338.84 | Facility | None | $213.80 | $269.15 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $407.38 | Professional | None | $269.15 | $295.12 | $407.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $29.51 Typical High $41.69 | Professional | RR · Rental | $28.18 | $29.51 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $223.87 Typical High $316.23 | Professional | UE · Used equipment | $213.80 | $223.87 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $467.74 | Facility | None | $446.68 | $446.68 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $331.13 | Facility | None | $269.15 | $302.00 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $1,445.44 | Professional | None | $218.78 | $302.00 | $1,445.44 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $38.90 | Professional | RR · Rental | $25.70 | $25.70 | $38.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $407.38 Median $851.14 Typical High $2,187.76 | Facility | None | $407.38 | $851.14 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $407.38 | Professional | None | $190.55 | $263.03 | $407.38 |
United Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $389.05 | Professional | None | $147.91 | $245.47 | $389.05 |
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 $77.62 Median $81.28 Typical High $109.65 | Professional | 52 · Reduced service | $77.62 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $43.65 | Professional | 53 · Discontinued | $30.90 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $32.36 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.22 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.49 | $16.22 | $21.88 |
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· 15th of 51
$295
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.