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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $331.13 | Professional | None | $263.03 | $269.15 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $562.34 Typical High $588.84 | Facility | None | $436.52 | $562.34 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $562.34 | Professional | None | $288.40 | $295.12 | $562.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.84 Median $28.84 Typical High $43.65 | Professional | RR · Rental | $28.84 | $28.84 | $43.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | UE · Used equipment | $218.78 | $218.78 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Facility | None | $691.83 | $691.83 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $562.34 | Facility | None | $295.12 | $295.12 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $2,691.53 | Professional | None | $218.78 | $295.12 | $2,691.53 |
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 $346.74 Median $457.09 Typical High $676.08 | Professional | None | $346.74 | $457.09 | $676.08 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
United Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $407.38 | Professional | None | $158.49 | $275.42 | $407.38 |
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 $134.90 Median $134.90 Typical High $165.96 | Professional | 52 · Reduced service | $134.90 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $33.11 |
Where Indiana sits
The same service costs 4.2 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· 38th of 51
$288
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.