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 $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,548.82 | Professional | None | $851.14 | $851.14 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,290.87 | Facility | None | $1,445.44 | $1,819.70 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $144.54 Median $169.82 Typical High $239.88 | Professional | RR · Rental | $144.54 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,096.48 Median $1,288.25 Typical High $1,819.70 | Professional | UE · Used equipment | $1,096.48 | $1,288.25 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,290.87 | Facility | None | $2,238.72 | $2,238.72 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,819.70 | Facility | None | $954.99 | $954.99 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $8,709.64 | Professional | None | $707.95 | $954.99 | $8,709.64 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $5,495.41 | Facility | None | $912.01 | $2,089.30 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,479.11 | $2,187.76 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $1,023.29 | Facility | None | $173.78 | $173.78 | $1,023.29 |
United Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,479.11 | Professional | None | $512.86 | $891.25 | $1,479.11 |
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 $426.58 Median $426.58 Typical High $776.25 | Professional | 52 · Reduced service | $426.58 | $426.58 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $309.03 | Professional | 53 · Discontinued | $169.82 | $169.82 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $229.09 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $154.88 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $154.88 |
Where Indiana sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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· 11th of 51
$1,479
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.