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 $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $724.44 | Professional | None | $549.54 | $575.44 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,258.93 | Facility | None | $933.25 | $1,174.90 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,174.90 | Professional | None | $588.84 | $588.84 | $1,174.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $58.88 Median $58.88 Typical High $87.10 | Professional | RR · Rental | $58.88 | $58.88 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $446.68 Median $446.68 Typical High $645.65 | Professional | UE · Used equipment | $446.68 | $446.68 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,548.82 | Facility | None | $1,513.56 | $1,513.56 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $1,174.90 | Facility | None | $758.58 | $758.58 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $5,370.32 | Professional | None | $549.54 | $758.58 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $3,715.35 | Facility | None | $912.01 | $2,187.76 | $3,715.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,659.59 | Professional | None | $741.31 | $977.24 | $1,659.59 |
United Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $645.65 | Facility | None | $575.44 | $575.44 | $645.65 |
United Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $851.14 | Professional | None | $323.59 | $575.44 | $851.14 |
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 $275.42 Median $288.40 Typical High $363.08 | Professional | 52 · Reduced service | $275.42 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $144.54 | Professional | 53 · Discontinued | $109.65 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $109.65 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $72.44 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $72.44 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 31st of 51
$589
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.