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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,258.93 | Professional | None | $676.08 | $676.08 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,479.11 | Facility | None | $1,096.48 | $1,412.54 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,412.54 | Professional | None | $831.76 | $831.76 | $1,412.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $117.49 | Professional | RR · Rental | $83.18 | $83.18 | $117.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | UE · Used equipment | $616.60 | $616.60 | $851.14 |
CareSource Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,691.53 | Facility | None | $2,570.40 | $2,570.40 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,412.54 | Facility | None | $891.25 | $891.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $7,762.47 | Professional | None | $645.65 | $891.25 | $7,762.47 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,041.74 Typical High $4,265.80 | Facility | None | $912.01 | $2,041.74 | $4,265.80 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,698.24 | Professional | None | $870.96 | $1,148.15 | $1,698.24 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Facility | None | $851.14 | $851.14 | $870.96 |
United Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,096.48 | Professional | None | $457.09 | $691.83 | $1,096.48 |
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 $338.84 Median $338.84 Typical High $616.60 | Professional | 52 · Reduced service | $338.84 | $338.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $251.19 | Professional | 53 · Discontinued | $134.90 | $134.90 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $186.21 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $125.89 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $125.89 |
Where Indiana sits
The same service costs 3.0 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· 39th of 51
$832
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.