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 $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,584.89 | Professional | None | $933.25 | $933.25 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,041.74 | Facility | None | $1,513.56 | $1,905.46 | $2,041.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,148.15 | $1,905.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $114.82 Typical High $169.82 | Professional | RR · Rental | $114.82 | $114.82 | $169.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Professional | UE · Used equipment | $851.14 | $851.14 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,388.44 | Facility | None | $3,311.31 | $3,311.31 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,905.46 | Facility | None | $1,174.90 | $1,174.90 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $10,471.29 | Professional | None | $851.14 | $1,174.90 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $5,754.40 | Facility | None | $912.01 | $2,089.30 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,548.82 | $2,344.23 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Facility | None | $870.96 | $870.96 | $933.25 |
United Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,479.11 | Professional | None | $630.96 | $933.25 | $1,479.11 |
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 $467.74 Median $467.74 Typical High $794.33 | Professional | 52 · Reduced service | $467.74 | $467.74 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $316.23 | Professional | 53 · Discontinued | $186.21 | $186.21 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $239.88 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $158.49 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $158.49 |
Where Indiana sits
The same service costs 3.0 times more in Montana 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· 31st of 51
$1,148
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.