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 $134.90 Median $134.90 Typical High $204.17 | Facility | None | $134.90 | $134.90 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $208.93 | Professional | None | $134.90 | $134.90 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $354.81 | Professional | None | $204.17 | $213.80 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $281.84 Typical High $295.12 | Facility | None | $218.78 | $281.84 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $281.84 | Professional | None | $158.49 | $158.49 | $281.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $22.39 | Professional | RR · Rental | $15.85 | $15.85 | $22.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $120.23 Typical High $165.96 | Professional | UE · Used equipment | $117.49 | $120.23 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $416.87 | Facility | None | $275.42 | $398.11 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $389.05 | Professional | None | $275.42 | $354.81 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $281.84 | Facility | None | $141.25 | $141.25 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $1,348.96 | Professional | None | $104.71 | $141.25 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $2,187.76 | Facility | None | $407.38 | $870.96 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $389.05 | Professional | None | $173.78 | $234.42 | $389.05 |
United Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $213.80 | Professional | None | $81.28 | $138.04 | $213.80 |
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 $67.61 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $67.61 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $38.90 | Professional | 53 · Discontinued | $26.92 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $19.50 |
Where Indiana sits
The same service costs 2.2 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· 35th of 51
$158
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.