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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | None | $147.91 | $147.91 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $302.00 Typical High $323.59 | Facility | None | $239.88 | $302.00 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $302.00 | Professional | None | $158.49 | $162.18 | $302.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $22.39 | Professional | RR · Rental | $15.85 | $15.85 | $22.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $169.82 | Professional | UE · Used equipment | $117.49 | $117.49 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $416.87 | Facility | None | $398.11 | $398.11 | $416.87 |
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 $1,412.54 | Professional | None | $138.04 | $190.55 | $1,412.54 |
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 $190.55 Median $245.47 Typical High $363.08 | Professional | None | $190.55 | $245.47 | $363.08 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Facility | None | $147.91 | $147.91 | $151.36 |
United Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $218.78 | Professional | None | $87.10 | $147.91 | $218.78 |
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 $74.13 Median $74.13 Typical High $95.50 | Professional | 52 · Reduced service | $74.13 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $38.90 | Professional | 53 · Discontinued | $29.51 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $28.84 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $19.50 |
Where Indiana sits
The same service costs 2.3 times more in Hawaii than in New Jersey. 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· 38th of 51
$158
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.