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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,071.52 | Professional | None | $758.58 | $758.58 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,659.59 | Facility | None | $1,230.27 | $1,584.89 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,584.89 | Professional | None | $794.33 | $794.33 | $1,584.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $79.43 Typical High $117.49 | Professional | RR · Rental | $79.43 | $79.43 | $117.49 |
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 $2,238.72 Median $2,238.72 Typical High $2,290.87 | Facility | None | $2,238.72 | $2,238.72 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,584.89 | Facility | None | $851.14 | $851.14 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $7,413.10 | Professional | None | $616.60 | $851.14 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $4,786.30 | Facility | None | $912.01 | $2,089.30 | $4,786.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,905.46 | Professional | None | $977.24 | $1,288.25 | $1,905.46 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $776.25 | Facility | None | $630.96 | $630.96 | $776.25 |
United Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $1,122.02 | Professional | None | $446.68 | $776.25 | $1,122.02 |
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 $380.19 Median $380.19 Typical High $537.03 | Professional | 52 · Reduced service | $380.19 | $380.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $213.80 | Professional | 53 · Discontinued | $151.36 | $151.36 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $162.18 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $107.15 |
Where Indiana sits
The same service costs 3.0 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· 32nd 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.