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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | None | $380.19 | $380.19 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $776.25 Typical High $831.76 | Facility | None | $616.60 | $776.25 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $776.25 | Professional | None | $380.19 | $398.11 | $776.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | RR · Rental | $38.02 | $38.02 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | UE · Used equipment | $288.40 | $288.40 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $977.24 | Facility | None | $954.99 | $954.99 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $776.25 | Facility | None | $407.38 | $407.38 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $3,715.35 | Professional | None | $295.12 | $407.38 | $3,715.35 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,398.83 | Facility | None | $912.01 | $2,089.30 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,096.48 | Professional | None | $489.78 | $645.65 | $1,096.48 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
United Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $562.34 | Professional | None | $218.78 | $380.19 | $562.34 |
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 $190.55 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $45.71 |
Where Indiana sits
The same service costs 3.5 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
$398
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.