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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $549.54 | Professional | None | $389.05 | $398.11 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $851.14 | Facility | None | $537.03 | $676.08 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,023.29 | Professional | None | $676.08 | $724.44 | $1,023.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $70.79 Median $72.44 Typical High $102.33 | Professional | RR · Rental | $70.79 | $72.44 | $102.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $537.03 Median $549.54 Typical High $758.58 | Professional | UE · Used equipment | $537.03 | $549.54 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Facility | None | $1,122.02 | $1,122.02 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $831.76 | Facility | None | $676.08 | $758.58 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $3,548.13 | Professional | None | $549.54 | $758.58 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $2,187.76 | Facility | None | $912.01 | $1,995.26 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,023.29 | Professional | None | $467.74 | $660.69 | $1,023.29 |
United Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $977.24 | Professional | None | $371.54 | $616.60 | $977.24 |
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 $194.98 Median $199.53 Typical High $269.15 | Professional | 52 · Reduced service | $194.98 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $109.65 | Professional | 53 · Discontinued | $77.62 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $81.28 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $54.95 |
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· 13th of 51
$724
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.