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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $239.88 | Professional | None | $169.82 | $169.82 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $346.74 Typical High $371.54 | Facility | None | $275.42 | $346.74 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $346.74 | Professional | None | $186.21 | $186.21 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $18.62 Typical High $27.54 | Professional | RR · Rental | $18.62 | $18.62 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | UE · Used equipment | $138.04 | $138.04 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $512.86 | Facility | None | $489.78 | $489.78 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $346.74 | Facility | None | $190.55 | $190.55 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $1,659.59 | Professional | None | $138.04 | $190.55 | $1,659.59 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $851.14 Median $954.99 Typical High $2,137.96 | Facility | None | $851.14 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $426.58 | Professional | None | $218.78 | $288.40 | $426.58 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Facility | None | $125.89 | $125.89 | $173.78 |
United Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $251.19 | Professional | None | $100.00 | $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 $85.11 Median $85.11 Typical High $120.23 | Professional | 52 · Reduced service | $85.11 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | 53 · Discontinued | $33.88 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $23.99 |
Where Indiana sits
The same service costs 2.7 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· 30th of 51
$186
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.