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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | None | $186.21 | $186.21 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $380.19 Typical High $407.38 | Facility | None | $302.00 | $380.19 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $380.19 | Professional | None | $218.78 | $218.78 | $380.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $32.36 | Professional | RR · Rental | $21.88 | $21.88 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $223.87 | Professional | UE · Used equipment | $162.18 | $162.18 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $537.03 | Facility | None | $512.86 | $512.86 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $380.19 | Facility | None | $245.47 | $245.47 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $1,905.46 | Professional | None | $177.83 | $245.47 | $1,905.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $467.74 | Professional | None | $239.88 | $316.23 | $467.74 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $234.42 | Facility | None | $199.53 | $199.53 | $234.42 |
United Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $281.84 | Professional | None | $117.49 | $186.21 | $281.84 |
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 $93.33 Median $93.33 Typical High $123.03 | Professional | 52 · Reduced service | $93.33 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | 53 · Discontinued | $37.15 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $25.12 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $25.12 |
Where Indiana sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 35th of 51
$219
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.