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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $69.18 | Professional | None | $48.98 | $48.98 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $107.15 | Facility | None | $79.43 | $100.00 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $100.00 | Professional | None | $52.48 | $52.48 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $7.41 | Professional | RR · Rental | $5.25 | $5.25 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | UE · Used equipment | $39.81 | $39.81 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $147.91 | Facility | None | $144.54 | $144.54 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $100.00 | Facility | None | $70.79 | $70.79 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $478.63 | Professional | None | $51.29 | $70.79 | $478.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $245.47 Median $912.01 Typical High $2,137.96 | Facility | None | $245.47 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $123.03 | Professional | None | $63.10 | $83.18 | $123.03 |
United Setting Professional Modifier None Typical Low $28.84 Median $48.98 Typical High $72.44 | Professional | None | $28.84 | $48.98 | $72.44 |
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 $24.55 Median $24.55 Typical High $34.67 | Professional | 52 · Reduced service | $24.55 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $13.80 | Professional | 53 · Discontinued | $9.77 | $9.77 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $10.23 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $6.92 |
Where Indiana sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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· 40th of 51
$52.48
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.