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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $912.01 | Professional | None | $660.69 | $660.69 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,445.44 | Facility | None | $1,071.52 | $1,348.96 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,348.96 | Professional | None | $794.33 | $794.33 | $1,348.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $79.43 Typical High $120.23 | Professional | RR · Rental | $79.43 | $79.43 | $120.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $588.84 Typical High $812.83 | Professional | UE · Used equipment | $588.84 | $588.84 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,995.26 | Facility | None | $1,905.46 | $1,905.46 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,348.96 | Facility | None | $831.76 | $831.76 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $7,413.10 | Professional | None | $602.56 | $831.76 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $4,168.69 | Facility | None | $912.01 | $2,187.76 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,905.46 | Professional | None | $851.14 | $1,122.02 | $1,905.46 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,348.96 | Facility | None | $870.96 | $870.96 | $1,348.96 |
United Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,047.13 | Professional | None | $436.52 | $660.69 | $1,047.13 |
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 $331.13 Median $331.13 Typical High $457.09 | Professional | 52 · Reduced service | $331.13 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | 53 · Discontinued | $131.83 | $131.83 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $138.04 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $91.20 |
Where Indiana sits
The same service costs 5.4 times more in Hawaii 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· 33rd of 51
$794
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.