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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $239.88 | Professional | None | $190.55 | $190.55 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $389.05 Typical High $416.87 | Facility | None | $309.03 | $389.05 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $389.05 | Professional | None | $208.93 | $208.93 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.89 Median $20.89 Typical High $29.51 | Professional | RR · Rental | $20.89 | $20.89 | $29.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $158.49 Typical High $223.87 | Professional | UE · Used equipment | $158.49 | $158.49 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $512.86 | Facility | None | $501.19 | $501.19 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $389.05 | Facility | None | $213.80 | $213.80 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $1,949.84 | Professional | None | $158.49 | $213.80 | $1,949.84 |
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 $245.47 Median $316.23 Typical High $467.74 | Professional | None | $245.47 | $316.23 | $467.74 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $257.04 | Facility | None | $229.09 | $229.09 | $257.04 |
United Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $281.84 | Professional | None | $114.82 | $190.55 | $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 $95.50 Median $95.50 Typical High $120.23 | Professional | 52 · Reduced service | $95.50 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $47.86 | Professional | 53 · Discontinued | $38.02 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $36.31 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $23.99 |
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· 37th of 51
$209
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.