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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | None | $288.40 | $288.40 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $630.96 | Facility | None | $467.74 | $602.56 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $602.56 | Professional | None | $323.59 | $323.59 | $602.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $47.86 | Professional | RR · Rental | $32.36 | $32.36 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | UE · Used equipment | $239.88 | $239.88 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $812.83 | Facility | None | $794.33 | $794.33 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $602.56 | Facility | None | $338.84 | $338.84 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $3,019.95 | Professional | None | $245.47 | $338.84 | $3,019.95 |
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 $371.54 Median $489.78 Typical High $724.44 | Professional | None | $371.54 | $489.78 | $724.44 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $407.38 | Facility | None | $354.81 | $354.81 | $407.38 |
United Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $436.52 | Professional | None | $177.83 | $295.12 | $436.52 |
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 $144.54 Median $144.54 Typical High $190.55 | Professional | 52 · Reduced service | $144.54 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $75.86 | Professional | 53 · Discontinued | $57.54 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $57.54 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $38.02 |
Where Indiana sits
The same service costs 4.2 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· 36th of 51
$324
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.