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 $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $501.19 | Professional | None | $251.19 | $251.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $537.03 Typical High $575.44 | Facility | None | $426.58 | $537.03 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $537.03 | Professional | None | $302.00 | $302.00 | $537.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $43.65 | Professional | RR · Rental | $30.20 | $30.20 | $43.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $229.09 Typical High $323.59 | Professional | UE · Used equipment | $229.09 | $229.09 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $758.58 | Facility | None | $724.44 | $724.44 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $537.03 | Facility | None | $346.74 | $346.74 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $2,691.53 | Professional | None | $251.19 | $346.74 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $660.69 | Professional | None | $338.84 | $446.68 | $660.69 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $251.19 | Facility | None | $173.78 | $173.78 | $251.19 |
United Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $446.68 | Professional | None | $165.96 | $263.03 | $446.68 |
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 $125.89 Median $125.89 Typical High $251.19 | Professional | 52 · Reduced service | $125.89 | $125.89 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $100.00 | Professional | 53 · Discontinued | $50.12 | $50.12 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $50.12 |
Where Indiana sits
The same service costs 2.9 times more in Iowa than in Kansas. 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· 40th of 51
$302
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.