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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $2,041.74 | Professional | None | $977.24 | $977.24 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,187.76 | Facility | None | $1,659.59 | $2,089.30 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,122.02 | $2,089.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $158.49 | Professional | RR · Rental | $112.20 | $112.20 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $1,174.90 | Professional | UE · Used equipment | $831.76 | $831.76 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,090.30 | Facility | None | $2,951.21 | $2,951.21 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,089.30 | Facility | None | $1,318.26 | $1,318.26 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $10,000.00 | Professional | None | $954.99 | $1,318.26 | $10,000.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $6,309.57 | Facility | None | $912.01 | $2,089.30 | $6,309.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,698.24 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,698.24 | Professional | None | $602.56 | $1,023.29 | $1,698.24 |
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 $489.78 Median $489.78 Typical High $1,023.29 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $407.38 | Professional | 53 · Discontinued | $194.98 | $194.98 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $309.03 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $204.17 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $204.17 |
Where Indiana sits
The same service costs 3.0 times more in Kansas 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· 36th of 51
$1,122
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.