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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $660.69 | Professional | None | $354.81 | $354.81 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $758.58 Typical High $812.83 | Facility | None | $602.56 | $758.58 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $758.58 | Professional | None | $398.11 | $398.11 | $758.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $56.23 | Professional | RR · Rental | $39.81 | $39.81 | $56.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | UE · Used equipment | $295.12 | $295.12 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $977.24 | Facility | None | $954.99 | $954.99 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $758.58 | Facility | None | $489.78 | $489.78 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $3,467.37 | Professional | None | $354.81 | $489.78 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,290.87 | Facility | None | $912.01 | $1,122.02 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $933.25 | Professional | None | $467.74 | $616.60 | $933.25 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $323.59 | Facility | None | $165.96 | $165.96 | $323.59 |
United Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $616.60 | Professional | None | $218.78 | $371.54 | $616.60 |
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 $177.83 Median $177.83 Typical High $323.59 | Professional | 52 · Reduced service | $177.83 | $177.83 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $131.83 | Professional | 53 · Discontinued | $70.79 | $70.79 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $97.72 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $66.07 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $66.07 |
Where Indiana sits
The same service costs 2.4 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· 36th of 51
$398
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.