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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,202.26 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $2,691.53 | Facility | None | $1,995.26 | $2,570.40 | $2,691.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,288.25 | $2,570.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | RR · Rental | $128.82 | $128.82 | $181.97 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | UE · Used equipment | $954.99 | $954.99 | $1,318.26 |
CareSource Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,162.28 | Facility | None | $3,090.30 | $3,090.30 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,570.40 | Facility | None | $1,621.81 | $1,621.81 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $11,748.98 | Professional | None | $1,174.90 | $1,621.81 | $11,748.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $7,762.47 | Facility | None | $912.01 | $2,089.30 | $7,762.47 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,584.89 | $2,089.30 | $3,090.30 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $1,380.38 | Facility | None | $776.25 | $776.25 | $1,380.38 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $2,089.30 | Professional | None | $691.83 | $1,258.93 | $2,089.30 |
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 $602.56 Median $602.56 Typical High $1,071.52 | Professional | 52 · Reduced service | $602.56 | $602.56 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $426.58 | Professional | 53 · Discontinued | $239.88 | $239.88 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $316.23 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $213.80 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $213.80 |
Where Indiana sits
The same service costs 2.7 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· 38th of 51
$1,288
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.