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 $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $660.69 | Professional | None | $389.05 | $389.05 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $851.14 | Facility | None | $630.96 | $812.83 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $812.83 | Professional | None | $478.63 | $478.63 | $812.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $67.61 | Professional | RR · Rental | $47.86 | $47.86 | $67.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $524.81 | Professional | UE · Used equipment | $363.08 | $363.08 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,412.54 | Facility | None | $1,380.38 | $1,380.38 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $812.83 | Facility | None | $489.78 | $489.78 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $4,365.16 | Professional | None | $363.08 | $489.78 | $4,365.16 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,511.89 | Facility | None | $912.01 | $2,089.30 | $2,511.89 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,122.02 | Professional | None | $501.19 | $660.69 | $1,122.02 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Facility | None | $478.63 | $478.63 | $524.81 |
United Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $630.96 | Professional | None | $263.03 | $398.11 | $630.96 |
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 $194.98 Median $194.98 Typical High $331.13 | Professional | 52 · Reduced service | $194.98 | $194.98 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $131.83 | Professional | 53 · Discontinued | $77.62 | $77.62 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $100.00 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $66.07 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $66.07 |
Where Indiana sits
The same service costs 3.2 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· 33rd of 51
$479
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.