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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $630.96 | Professional | None | $467.74 | $478.63 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $776.25 Typical High $977.24 | Facility | None | $616.60 | $776.25 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,174.90 | Professional | None | $776.25 | $794.33 | $1,174.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $79.43 Typical High $114.82 | Professional | RR · Rental | $79.43 | $79.43 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $602.56 Typical High $870.96 | Professional | UE · Used equipment | $602.56 | $602.56 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,348.96 | Facility | None | $1,288.25 | $1,288.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $851.14 Typical High $954.99 | Facility | None | $776.25 | $851.14 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $4,168.69 | Professional | None | $616.60 | $851.14 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,344.23 | Facility | None | $912.01 | $1,148.15 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,258.93 | Professional | None | $537.03 | $758.58 | $1,258.93 |
United Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,230.27 | Professional | None | $416.87 | $776.25 | $1,230.27 |
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 $229.09 Median $239.88 Typical High $316.23 | Professional | 52 · Reduced service | $229.09 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $125.89 | Professional | 53 · Discontinued | $93.33 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $93.33 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $63.10 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $63.10 |
Where Indiana sits
The same service costs 2.8 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· 24th of 51
$794
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.