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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $204.17 | Professional | None | $144.54 | $144.54 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $302.00 Typical High $316.23 | Facility | None | $239.88 | $302.00 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $302.00 | Professional | None | $177.83 | $181.97 | $302.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $25.12 | Professional | RR · Rental | $17.78 | $17.78 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $190.55 | Professional | UE · Used equipment | $131.83 | $131.83 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $446.68 | Facility | None | $426.58 | $426.58 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $302.00 | Facility | None | $190.55 | $190.55 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $1,621.81 | Professional | None | $138.04 | $190.55 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $741.31 Median $912.01 Typical High $2,137.96 | Facility | None | $741.31 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $363.08 | Professional | None | $186.21 | $245.47 | $363.08 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $194.98 | Facility | None | $190.55 | $190.55 | $194.98 |
United Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $234.42 | Professional | None | $97.72 | $147.91 | $234.42 |
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 $72.44 Median $72.44 Typical High $102.33 | Professional | 52 · Reduced service | $72.44 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $41.69 | Professional | 53 · Discontinued | $29.51 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $30.90 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $20.42 |
Where Indiana sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 33rd of 51
$178
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.