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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $616.60 | Professional | None | $363.08 | $380.19 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $831.76 | Facility | None | $537.03 | $676.08 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $954.99 | Professional | None | $676.08 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $97.72 | Professional | RR · Rental | $69.18 | $69.18 | $97.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $512.86 Median $512.86 Typical High $724.44 | Professional | UE · Used equipment | $512.86 | $512.86 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,071.52 | Facility | None | $1,047.13 | $1,047.13 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $676.08 Typical High $707.95 | Facility | None | $630.96 | $676.08 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $3,311.31 | Professional | None | $467.74 | $630.96 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $2,187.76 | Facility | None | $912.01 | $1,995.26 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $954.99 | Professional | None | $416.87 | $575.44 | $954.99 |
United Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $870.96 | Professional | None | $323.59 | $537.03 | $870.96 |
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 $181.97 Median $190.55 Typical High $251.19 | Professional | 52 · Reduced service | $181.97 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $75.86 Typical High $100.00 | Professional | 53 · Discontinued | $74.13 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $57.54 Typical High $75.86 | Professional | 55 · Aftercare only | $54.95 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $50.12 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $50.12 |
Where Indiana sits
The same service costs 2.2 times more in Kansas 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· 13th of 51
$692
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.