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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,023.29 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,238.72 | Facility | None | $1,659.59 | $2,137.96 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,148.15 | $2,137.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $114.82 Typical High $162.18 | Professional | RR · Rental | $114.82 | $114.82 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | UE · Used equipment | $851.14 | $851.14 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,818.38 | Facility | None | $2,754.23 | $2,754.23 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,137.96 | Facility | None | $1,288.25 | $1,288.25 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $10,715.19 | Professional | None | $933.25 | $1,288.25 | $10,715.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $6,456.54 | Facility | None | $912.01 | $2,089.30 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,737.80 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Facility | None | $1,258.93 | $1,258.93 | $1,318.26 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,513.56 | Professional | None | $630.96 | $1,047.13 | $1,513.56 |
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 $512.86 Median $512.86 Typical High $660.69 | Professional | 52 · Reduced service | $512.86 | $512.86 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 53 · Discontinued | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $131.83 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $131.83 |
Where Indiana sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 39th of 51
$1,148
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.