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 $162.18 Median $165.96 Typical High $181.97 | Professional | None | $162.18 | $165.96 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $346.74 Typical High $363.08 | Facility | None | $275.42 | $346.74 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $346.74 | Professional | None | $154.88 | $154.88 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $21.88 | Professional | RR · Rental | $15.49 | $15.49 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $165.96 | Professional | UE · Used equipment | $117.49 | $117.49 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $389.05 | Facility | None | $380.19 | $380.19 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $346.74 | Facility | None | $158.49 | $158.49 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $1,479.11 | Professional | None | $117.49 | $158.49 | $1,479.11 |
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 $141.25 Median $141.25 Typical High $169.82 | Facility | None | $141.25 | $141.25 | $169.82 |
United Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $251.19 | Professional | None | $85.11 | $162.18 | $251.19 |
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 $81.28 Median $83.18 Typical High $91.20 | Professional | 52 · Reduced service | $81.28 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.88 Typical High $37.15 | Professional | 53 · Discontinued | $32.36 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $25.12 Typical High $27.54 | Professional | 55 · Aftercare only | $23.99 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $18.20 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $18.20 |
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· 27th of 51
$162
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.