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 $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,000.00 | Professional | None | $691.83 | $691.83 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,513.56 | Facility | None | $1,148.15 | $1,445.44 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $1,445.44 | Professional | None | $831.76 | $851.14 | $1,445.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $117.49 | Professional | RR · Rental | $83.18 | $83.18 | $117.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $630.96 Typical High $851.14 | Professional | UE · Used equipment | $616.60 | $630.96 | $851.14 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,137.96 | Facility | None | $2,089.30 | $2,089.30 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,445.44 | Facility | None | $831.76 | $831.76 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $6,918.31 | Professional | None | $616.60 | $831.76 | $6,918.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $4,466.84 | Facility | None | $912.01 | $2,187.76 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,995.26 | Professional | None | $891.25 | $1,174.90 | $1,995.26 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Facility | None | $630.96 | $630.96 | $794.33 |
United Setting Professional Modifier None Typical Low $416.87 Median $707.95 Typical High $1,047.13 | Professional | None | $416.87 | $707.95 | $1,047.13 |
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 $346.74 Median $346.74 Typical High $501.19 | Professional | 52 · Reduced service | $346.74 | $346.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $199.53 | Professional | 53 · Discontinued | $138.04 | $138.04 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $151.36 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $100.00 |
Where Indiana sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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· 25th of 51
$832
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.