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 $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $831.76 | Professional | None | $588.84 | $588.84 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,288.25 | Facility | None | $954.99 | $1,202.26 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,202.26 | Professional | None | $707.95 | $741.31 | $1,202.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | RR · Rental | $70.79 | $70.79 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $537.03 Median $537.03 Typical High $758.58 | Professional | UE · Used equipment | $537.03 | $537.03 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,778.28 | Facility | None | $1,698.24 | $1,698.24 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,202.26 | Facility | None | $741.31 | $741.31 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $6,606.93 | Professional | None | $537.03 | $741.31 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,137.96 Typical High $3,715.35 | Facility | None | $912.01 | $2,137.96 | $3,715.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,698.24 | Professional | None | $758.58 | $1,000.00 | $1,698.24 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $912.01 | Facility | None | $776.25 | $776.25 | $912.01 |
United Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $933.25 | Professional | None | $389.05 | $588.84 | $933.25 |
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 $288.40 Median $288.40 Typical High $416.87 | Professional | 52 · Reduced service | $288.40 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $165.96 | Professional | 53 · Discontinued | $117.49 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $83.18 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $83.18 |
Where Indiana sits
The same service costs 4.6 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· 39th of 51
$708
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.