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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $602.56 | Professional | None | $316.23 | $316.23 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $707.95 | Facility | None | $537.03 | $676.08 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $676.08 | Professional | None | $371.54 | $371.54 | $676.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $37.15 Typical High $52.48 | Professional | RR · Rental | $37.15 | $37.15 | $52.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | UE · Used equipment | $275.42 | $275.42 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $676.08 | Facility | None | $426.58 | $426.58 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $3,388.44 | Professional | None | $309.03 | $426.58 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,000.00 Typical High $2,137.96 | Facility | None | $912.01 | $1,000.00 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $812.83 | Professional | None | $416.87 | $549.54 | $812.83 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $380.19 | Facility | None | $338.84 | $338.84 | $380.19 |
United Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $549.54 | Professional | None | $199.53 | $331.13 | $549.54 |
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 $158.49 Median $158.49 Typical High $302.00 | Professional | 52 · Reduced service | $158.49 | $158.49 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $120.23 | Professional | 53 · Discontinued | $63.10 | $63.10 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $91.20 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $60.26 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $60.26 |
Where Indiana sits
The same service costs 2.7 times more in Hawaii 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· 39th of 51
$372
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.