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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $489.78 | Professional | None | $346.74 | $346.74 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $707.95 Typical High $758.58 | Facility | None | $562.34 | $707.95 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $707.95 | Professional | None | $389.05 | $389.05 | $707.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | RR · Rental | $38.90 | $38.90 | $56.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | UE · Used equipment | $295.12 | $295.12 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Facility | None | $1,000.00 | $1,000.00 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $707.95 | Facility | None | $436.52 | $436.52 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $3,388.44 | Professional | None | $316.23 | $436.52 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,047.13 Typical High $2,187.76 | Facility | None | $912.01 | $1,047.13 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $707.95 | Professional | None | $467.74 | $588.84 | $707.95 |
United Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $537.03 | Professional | None | $204.17 | $346.74 | $537.03 |
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 $169.82 Median $169.82 Typical High $245.47 | Professional | 52 · Reduced service | $169.82 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $97.72 | Professional | 53 · Discontinued | $69.18 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $72.44 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $48.98 |
Where Indiana sits
The same service costs 2.3 times more in Montana 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· 36th of 51
$389
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.