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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $758.58 | Professional | None | $537.03 | $537.03 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $1,096.48 Typical High $1,096.48 | Professional | None | $616.60 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,174.90 | Facility | None | $870.96 | $1,096.48 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $1,096.48 | Professional | None | $575.44 | $602.56 | $1,096.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $57.54 Typical High $83.18 | Professional | RR · Rental | $57.54 | $57.54 | $83.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $436.52 Median $436.52 Typical High $616.60 | Professional | UE · Used equipment | $436.52 | $436.52 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,621.81 | Facility | None | $1,584.89 | $1,584.89 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,096.48 | Facility | None | $724.44 | $891.25 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $5,248.07 | Professional | None | $537.03 | $724.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,621.81 Typical High $3,311.31 | Facility | None | $912.01 | $1,621.81 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,318.26 | Professional | None | $676.08 | $891.25 | $1,318.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $794.33 | Professional | None | $316.23 | $537.03 | $794.33 |
2 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 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $114.82 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $75.86 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $75.86 |
Where Indiana sits
The same service costs 2.0 times more in Montana 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· 41st of 51
$575
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.