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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $213.80 | Professional | None | $181.97 | $190.55 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $389.05 Typical High $416.87 | Facility | None | $309.03 | $389.05 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $389.05 | Professional | None | $173.78 | $173.78 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.38 Median $17.38 Typical High $25.12 | Professional | RR · Rental | $17.38 | $17.38 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | UE · Used equipment | $131.83 | $131.83 | $186.21 |
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 $223.87 Median $223.87 Typical High $389.05 | Facility | None | $223.87 | $223.87 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $1,621.81 | Professional | None | $165.96 | $223.87 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $467.74 | Professional | None | $245.47 | $316.23 | $467.74 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $208.93 | Facility | None | $190.55 | $190.55 | $208.93 |
United Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $281.84 | Professional | None | $95.50 | $186.21 | $281.84 |
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 $91.20 Median $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $91.20 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $43.65 | Professional | 53 · Discontinued | $36.31 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.18 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $21.38 |
Where Indiana sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 26th of 51
$191
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.