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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | None | $245.47 | $245.47 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $512.86 Typical High $537.03 | Facility | None | $407.38 | $512.86 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $512.86 | Professional | None | $281.84 | $281.84 | $512.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $41.69 | Professional | RR · Rental | $28.18 | $28.18 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $208.93 Typical High $295.12 | Professional | UE · Used equipment | $208.93 | $208.93 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $691.83 | Facility | None | $660.69 | $660.69 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $512.86 | Facility | None | $354.81 | $354.81 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $2,570.40 | Professional | None | $257.04 | $354.81 | $2,570.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,187.76 | Facility | None | $758.58 | $1,513.56 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $707.95 | Professional | None | $316.23 | $416.87 | $707.95 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $309.03 | Facility | None | $234.42 | $234.42 | $309.03 |
United Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $371.54 | Professional | None | $151.36 | $251.19 | $371.54 |
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 $123.03 Median $123.03 Typical High $162.18 | Professional | 52 · Reduced service | $123.03 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $64.57 | Professional | 53 · Discontinued | $48.98 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $32.36 |
Where Indiana sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 26th of 51
$282
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.