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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,819.70 | $1,819.70 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $3,981.07 | Facility | None | $2,951.21 | $3,801.89 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,949.84 | $1,949.84 | $3,801.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $194.98 Median $194.98 Typical High $281.84 | Professional | RR · Rental | $194.98 | $194.98 | $281.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,479.11 Median $1,479.11 Typical High $2,041.74 | Professional | UE · Used equipment | $1,479.11 | $1,479.11 | $2,041.74 |
CareSource Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,888.44 | Facility | None | $5,754.40 | $5,754.40 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,801.89 | Facility | None | $1,995.26 | $1,995.26 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $18,197.01 | Professional | None | $1,479.11 | $1,995.26 | $18,197.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,495.41 Typical High $11,748.98 | Facility | None | $912.01 | $5,495.41 | $11,748.98 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,344.23 Median $3,090.30 Typical High $5,248.07 | Professional | None | $2,344.23 | $3,090.30 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,951.21 | Facility | None | $2,137.96 | $2,137.96 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,862.09 | $2,754.23 |
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 $912.01 Median $912.01 Typical High $1,380.38 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $549.54 | Professional | 53 · Discontinued | $363.08 | $363.08 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $416.87 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $275.42 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $275.42 |
Where Indiana sits
The same service costs 4.4 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· 32nd of 51
$1,950
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.