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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $151.36 | Professional | None | $107.15 | $112.20 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $190.55 Typical High $234.42 | Facility | None | $147.91 | $190.55 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $194.98 Typical High $269.15 | Professional | None | $190.55 | $194.98 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $27.54 | Professional | RR · Rental | $19.50 | $19.50 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $144.54 Median $144.54 Typical High $213.80 | Professional | UE · Used equipment | $144.54 | $144.54 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $323.59 | Facility | None | $316.23 | $316.23 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $213.80 Typical High $229.09 | Facility | None | $190.55 | $213.80 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $1,000.00 | Professional | None | $154.88 | $213.80 | $1,000.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $2,137.96 | Facility | None | $457.09 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $281.84 | Professional | None | $131.83 | $186.21 | $281.84 |
United Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $269.15 | Professional | None | $102.33 | $173.78 | $269.15 |
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 $53.70 Median $56.23 Typical High $75.86 | Professional | 52 · Reduced service | $53.70 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $30.20 | Professional | 53 · Discontinued | $21.88 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $16.22 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.22 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.72 | $11.22 | $15.14 |
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· 21st of 51
$195
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.