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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $208.93 | Professional | None | $162.18 | $165.96 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $346.74 Typical High $363.08 | Facility | None | $269.15 | $346.74 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $346.74 | Professional | None | $181.97 | $181.97 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $26.30 | Professional | RR · Rental | $18.20 | $18.20 | $26.30 |
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 $436.52 Median $436.52 Typical High $457.09 | Facility | None | $436.52 | $436.52 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $218.78 Typical High $346.74 | Facility | None | $208.93 | $218.78 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $1,698.24 | Professional | None | $158.49 | $218.78 | $1,698.24 |
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 $213.80 Median $281.84 Typical High $416.87 | Professional | None | $213.80 | $281.84 | $416.87 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
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 $81.28 Median $83.18 Typical High $104.71 | Professional | 52 · Reduced service | $81.28 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $42.66 | Professional | 53 · Discontinued | $32.36 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.12 Typical High $31.62 | Professional | 55 · Aftercare only | $24.55 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $20.89 |
Where Indiana sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 34th of 51
$182
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.