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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $794.33 | Professional | None | $562.34 | $562.34 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,230.27 | Facility | None | $912.01 | $1,148.15 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,148.15 | Professional | None | $660.69 | $660.69 | $1,148.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $95.50 | Professional | RR · Rental | $66.07 | $66.07 | $95.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $489.78 Median $489.78 Typical High $691.83 | Professional | UE · Used equipment | $489.78 | $489.78 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,698.24 | Facility | None | $1,621.81 | $1,621.81 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,148.15 | Facility | None | $741.31 | $741.31 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $5,754.40 | Professional | None | $537.03 | $741.31 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,698.24 Typical High $3,467.37 | Facility | None | $912.01 | $1,698.24 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,412.54 | Professional | None | $707.95 | $933.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Facility | None | $645.65 | $645.65 | $691.83 |
United Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $831.76 | Professional | None | $346.74 | $562.34 | $831.76 |
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 $281.84 Median $281.84 Typical High $398.11 | Professional | 52 · Reduced service | $281.84 | $281.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $158.49 | Professional | 53 · Discontinued | $112.20 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $117.49 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $79.43 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $79.43 |
Where Indiana sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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
$661
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.