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 $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $6,165.95 | Professional | None | $3,548.13 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $7,585.78 Typical High $8,128.31 | Facility | None | $6,025.60 | $7,585.78 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $7,585.78 | Professional | None | $3,801.89 | $3,801.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $380.19 Median $380.19 Typical High $537.03 | Professional | RR · Rental | $380.19 | $380.19 | $537.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,818.38 Median $2,818.38 Typical High $3,981.07 | Professional | UE · Used equipment | $2,818.38 | $2,818.38 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $9,332.54 | Facility | None | $8,912.51 | $8,912.51 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $7,585.78 | Facility | None | $4,897.79 | $4,897.79 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $4,897.79 Typical High $34,673.69 | Professional | None | $3,548.13 | $4,897.79 | $34,673.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $22,908.68 | Facility | None | $912.01 | $2,089.30 | $22,908.68 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $4,786.30 Median $6,309.57 Typical High $9,332.54 | Professional | None | $4,786.30 | $6,309.57 | $9,332.54 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,370.32 | Facility | None | $4,073.80 | $4,073.80 | $5,370.32 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $3,715.35 Typical High $6,309.57 | Professional | None | $2,041.74 | $3,715.35 | $6,309.57 |
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 $1,778.28 Median $1,778.28 Typical High $3,090.30 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $1,230.27 | Professional | 53 · Discontinued | $707.95 | $707.95 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $933.25 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $616.60 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $616.60 |
Where Indiana sits
The same service costs 3.5 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· 37th of 51
$3,802
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.