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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $645.65 | Professional | None | $416.87 | $416.87 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | None | $630.96 | $630.96 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $851.14 Typical High $933.25 | Facility | None | $676.08 | $851.14 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $851.14 | Professional | None | $537.03 | $549.54 | $851.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $75.86 | Professional | RR · Rental | $53.70 | $53.70 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | UE · Used equipment | $407.38 | $407.38 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,380.38 | Facility | None | $1,348.96 | $1,348.96 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $851.14 | Facility | None | $549.54 | $549.54 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $4,466.84 | Professional | None | $398.11 | $549.54 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,023.29 | Professional | None | $524.81 | $691.83 | $1,023.29 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Facility | None | $331.13 | $331.13 | $436.52 |
United Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $630.96 | Professional | None | $269.15 | $416.87 | $630.96 |
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 $204.17 Median $204.17 Typical High $323.59 | Professional | 52 · Reduced service | $204.17 | $204.17 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $128.82 | Professional | 53 · Discontinued | $83.18 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $97.72 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $64.57 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $64.57 |
Where Indiana sits
The same service costs 2.4 times more in Iowa 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· 32nd of 51
$537
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.