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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $169.82 | Professional | None | $125.89 | $128.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $288.40 | Facility | None | $181.97 | $229.09 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $275.42 | Professional | None | $190.55 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $19.95 Typical High $28.18 | Professional | RR · Rental | $19.95 | $19.95 | $28.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | UE · Used equipment | $147.91 | $147.91 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $371.54 | Facility | None | $354.81 | $354.81 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $239.88 | Facility | None | $213.80 | $213.80 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $1,148.15 | Professional | None | $158.49 | $213.80 | $1,148.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $2,137.96 | Facility | None | $562.34 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $281.84 | Professional | None | $144.54 | $208.93 | $281.84 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Facility | None | $213.80 | $213.80 | $234.42 |
United Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $251.19 | Professional | None | $107.15 | $169.82 | $251.19 |
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 $63.10 Median $63.10 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $25.12 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $25.70 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $16.98 |
Where Indiana sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 29th of 51
$200
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.