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 $380.19 Median $398.11 Typical High $446.68 | Professional | None | $380.19 | $398.11 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $870.96 | Facility | None | $645.65 | $812.83 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $812.83 | Professional | None | $371.54 | $371.54 | $812.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $37.15 Typical High $56.23 | Professional | RR · Rental | $37.15 | $37.15 | $56.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | UE · Used equipment | $281.84 | $281.84 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $954.99 | Facility | None | $933.25 | $933.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $812.83 | Facility | None | $398.11 | $398.11 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $3,548.13 | Professional | None | $295.12 | $398.11 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,202.26 Typical High $2,454.71 | Facility | None | $912.01 | $1,202.26 | $2,454.71 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,000.00 | Professional | None | $501.19 | $660.69 | $1,000.00 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Facility | None | $295.12 | $295.12 | $331.13 |
United Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $588.84 | Professional | None | $213.80 | $398.11 | $588.84 |
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 $190.55 Median $199.53 Typical High $223.87 | Professional | 52 · Reduced service | $190.55 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $44.67 |
Where Indiana sits
The same service costs 3.0 times more in Montana 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· 30th of 51
$389
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.