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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,071.52 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,344.23 | Facility | None | $1,737.80 | $2,187.76 | $2,344.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,096.48 | $2,187.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $154.88 | Professional | RR · Rental | $109.65 | $109.65 | $154.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $812.83 Median $812.83 Typical High $1,122.02 | Professional | UE · Used equipment | $812.83 | $812.83 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,818.38 | Facility | None | $2,691.53 | $2,691.53 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,187.76 | Facility | None | $1,380.38 | $1,380.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $9,772.37 | Professional | None | $1,023.29 | $1,380.38 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $6,606.93 | Facility | None | $912.01 | $2,089.30 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,778.28 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Facility | None | $1,000.00 | $1,000.00 | $1,174.90 |
United Setting Professional Modifier None Typical Low $588.84 Median $1,071.52 Typical High $1,584.89 | Professional | None | $588.84 | $1,071.52 | $1,584.89 |
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 $524.81 Median $537.03 Typical High $645.65 | Professional | 52 · Reduced service | $524.81 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $263.03 | Professional | 53 · Discontinued | $208.93 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $128.82 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $128.82 |
Where Indiana sits
The same service costs 2.7 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· 30th of 51
$1,096
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.