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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $398.11 | Professional | None | $281.84 | $281.84 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $575.44 Typical High $616.60 | Facility | None | $457.09 | $575.44 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $575.44 | Professional | None | $234.42 | $302.00 | $575.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.91 Median $30.20 Typical High $43.65 | Professional | RR · Rental | $22.91 | $30.20 | $43.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $229.09 Typical High $309.03 | Professional | UE · Used equipment | $199.53 | $229.09 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $851.14 | Facility | None | $831.76 | $831.76 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $575.44 | Facility | None | $316.23 | $316.23 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $2,754.23 | Professional | None | $229.09 | $316.23 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $691.83 | Professional | None | $354.81 | $467.74 | $691.83 |
United Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $416.87 | Professional | None | $165.96 | $281.84 | $416.87 |
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 $141.25 Median $141.25 Typical High $199.53 | Professional | 52 · Reduced service | $141.25 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $79.43 | Professional | 53 · Discontinued | $56.23 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $39.81 |
Where Indiana sits
The same service costs 2.6 times more in Montana 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· 37th of 51
$302
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.