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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $158.49 | Professional | None | $112.20 | $112.20 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $245.47 | Facility | None | $181.97 | $229.09 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $229.09 | Professional | None | $134.90 | $134.90 | $229.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $19.95 | Professional | RR · Rental | $13.49 | $13.49 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $144.54 | Professional | UE · Used equipment | $100.00 | $100.00 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $338.84 | Facility | None | $331.13 | $331.13 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $229.09 | Facility | None | $141.25 | $141.25 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $1,318.26 | Professional | None | $102.33 | $141.25 | $1,318.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $2,137.96 | Facility | None | $562.34 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $275.42 | Professional | None | $144.54 | $190.55 | $275.42 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $389.05 | Facility | None | $151.36 | $151.36 | $389.05 |
United Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $177.83 | Professional | None | $75.86 | $112.20 | $177.83 |
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 $56.23 Median $56.23 Typical High $79.43 | Professional | 52 · Reduced service | $56.23 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $31.62 | Professional | 53 · Discontinued | $22.39 | $22.39 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $23.44 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $15.85 |
Where Indiana sits
The same service costs 8.1 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
$135
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.