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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $436.52 | Professional | None | $363.08 | $371.54 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | None | $575.44 | $588.84 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $758.58 Typical High $812.83 | Facility | None | $602.56 | $758.58 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $758.58 | Professional | None | $380.19 | $389.05 | $758.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $53.70 | Professional | RR · Rental | $38.02 | $38.02 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $281.84 Typical High $398.11 | Professional | UE · Used equipment | $281.84 | $281.84 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $933.25 | Facility | None | $912.01 | $912.01 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $758.58 | Facility | None | $524.81 | $524.81 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $3,548.13 | Professional | None | $380.19 | $524.81 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,290.87 | Facility | None | $912.01 | $1,122.02 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $912.01 | Professional | None | $467.74 | $616.60 | $912.01 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
United Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $549.54 | Professional | None | $208.93 | $371.54 | $549.54 |
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 $186.21 Typical High $218.78 | Professional | 52 · Reduced service | $181.97 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $72.44 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $43.65 |
Where Indiana sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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
$389
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.