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 $933.25 | Professional | None | $758.58 | $758.58 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,659.59 | Facility | None | $1,230.27 | $1,548.82 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,548.82 | Professional | None | $812.83 | $812.83 | $1,548.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $114.82 | Professional | RR · Rental | $81.28 | $81.28 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $602.56 Typical High $870.96 | Professional | UE · Used equipment | $602.56 | $602.56 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,949.84 | $1,949.84 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,548.82 | Facility | None | $831.76 | $831.76 | $1,548.82 |
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 $2,089.30 Typical High $4,677.35 | Facility | None | $912.01 | $2,089.30 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,862.09 | Professional | None | $954.99 | $1,258.93 | $1,862.09 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $891.25 | Facility | None | $870.96 | $870.96 | $891.25 |
United Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,122.02 | Professional | None | $446.68 | $758.58 | $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 $467.74 | Professional | 52 · Reduced service | $380.19 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $93.33 |
Where Indiana sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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
$813
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.