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 $3,311.31 | Professional | None | $1,819.70 | $1,819.70 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $3,890.45 Typical High $4,168.69 | Facility | None | $3,090.30 | $3,890.45 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,995.26 | $1,995.26 | $3,890.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $199.53 Median $199.53 Typical High $281.84 | Professional | RR · Rental | $199.53 | $199.53 | $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 $4,786.30 Median $4,786.30 Typical High $5,011.87 | Facility | None | $4,786.30 | $4,786.30 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,890.45 | Facility | None | $2,454.71 | $2,454.71 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $18,620.87 | Professional | None | $1,819.70 | $2,454.71 | $18,620.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $11,748.98 | Facility | None | $912.01 | $2,089.30 | $11,748.98 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,398.83 Median $3,162.28 Typical High $4,677.35 | Professional | None | $2,398.83 | $3,162.28 | $4,677.35 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,290.87 | Facility | None | $2,187.76 | $2,187.76 | $2,290.87 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,096.48 | $1,905.46 | $3,162.28 |
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 $1,659.59 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $660.69 | Professional | 53 · Discontinued | $363.08 | $363.08 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $501.19 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $331.13 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $331.13 |
Where Indiana sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 38th of 51
$1,995
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.