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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $162.18 | Professional | None | $125.89 | $125.89 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $263.03 Typical High $275.42 | Facility | None | $208.93 | $263.03 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $263.03 | Professional | None | $138.04 | $138.04 | $263.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $20.42 | Professional | RR · Rental | $13.80 | $13.80 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | UE · Used equipment | $102.33 | $102.33 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $346.74 | Facility | None | $338.84 | $338.84 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $263.03 | Facility | None | $165.96 | $165.96 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $1,288.25 | Professional | None | $120.23 | $165.96 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $645.65 Median $912.01 Typical High $2,137.96 | Facility | None | $645.65 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $316.23 | Professional | None | $162.18 | $213.80 | $316.23 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Facility | None | $154.88 | $154.88 | $213.80 |
United Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $190.55 | Professional | None | $77.62 | $128.82 | $190.55 |
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 $63.10 Median $63.10 Typical High $81.28 | Professional | 52 · Reduced service | $63.10 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $32.36 | Professional | 53 · Discontinued | $25.70 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $24.55 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $16.22 |
Where Indiana sits
The same service costs 4.4 times more in Hawaii than in Florida. 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· 41st of 51
$138
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.