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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $316.23 | Professional | None | $165.96 | $165.96 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $346.74 Typical High $363.08 | Facility | None | $269.15 | $346.74 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $346.74 | Professional | None | $204.17 | $204.17 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $28.84 | Professional | RR · Rental | $20.42 | $20.42 | $28.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | UE · Used equipment | $154.88 | $154.88 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $676.08 | Facility | None | $645.65 | $645.65 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $346.74 | Facility | None | $218.78 | $218.78 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $1,819.70 | Professional | None | $158.49 | $218.78 | $1,819.70 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $851.14 Median $954.99 Typical High $2,137.96 | Facility | None | $851.14 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $416.87 | Professional | None | $213.80 | $281.84 | $416.87 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $169.82 | Facility | None | $36.31 | $36.31 | $169.82 |
United Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $269.15 | Professional | None | $112.20 | $169.82 | $269.15 |
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 $83.18 Median $83.18 Typical High $158.49 | Professional | 52 · Reduced service | $83.18 | $83.18 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $63.10 | Professional | 53 · Discontinued | $33.11 | $33.11 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $46.77 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $31.62 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $31.62 |
Where Indiana sits
The same service costs 3.6 times more in Georgia than in Alaska. 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
$204
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.