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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $602.56 | Professional | None | $457.09 | $457.09 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $954.99 Typical High $1,000.00 | Facility | None | $741.31 | $954.99 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $954.99 | Professional | None | $489.78 | $489.78 | $954.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $48.98 Typical High $72.44 | Professional | RR · Rental | $48.98 | $48.98 | $72.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $524.81 | Professional | UE · Used equipment | $363.08 | $363.08 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Facility | None | $1,258.93 | $1,258.93 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $954.99 | Facility | None | $501.19 | $501.19 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $4,570.88 | Professional | None | $363.08 | $501.19 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $2,884.03 | Facility | None | $912.01 | $1,380.38 | $2,884.03 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,148.15 | Professional | None | $588.84 | $776.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Facility | None | $537.03 | $537.03 | $562.34 |
United Setting Professional Modifier None Typical Low $269.15 Median $467.74 Typical High $691.83 | Professional | None | $269.15 | $467.74 | $691.83 |
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 $229.09 Median $229.09 Typical High $302.00 | Professional | 52 · Reduced service | $229.09 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $120.23 | Professional | 53 · Discontinued | $91.20 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $91.20 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $60.26 |
Where Indiana sits
The same service costs 3.9 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· 31st of 51
$490
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.