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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | None | $141.25 | $141.25 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $309.03 | Facility | None | $229.09 | $288.40 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $288.40 | Professional | None | $162.18 | $162.18 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.22 Median $16.22 Typical High $24.55 | Professional | RR · Rental | $16.22 | $16.22 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $123.03 Typical High $173.78 | Professional | UE · Used equipment | $123.03 | $123.03 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $407.38 | Facility | None | $398.11 | $398.11 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $288.40 | Facility | None | $169.82 | $169.82 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $1,513.56 | Professional | None | $125.89 | $169.82 | $1,513.56 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $2,137.96 | Facility | None | $707.95 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $346.74 | Professional | None | $181.97 | $239.88 | $346.74 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $229.09 | Facility | None | $181.97 | $181.97 | $229.09 |
United Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $218.78 | Professional | None | $91.20 | $141.25 | $218.78 |
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 $70.79 Median $70.79 Typical High $95.50 | Professional | 52 · Reduced service | $70.79 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $38.02 | Professional | 53 · Discontinued | $28.18 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $19.05 |
Where Indiana sits
The same service costs 4.7 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· 33rd 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.