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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $363.08 | Professional | None | $190.55 | $190.55 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $436.52 | Facility | None | $323.59 | $407.38 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $407.38 | Professional | None | $213.80 | $218.78 | $407.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.38 Median $21.38 Typical High $30.20 | Professional | RR · Rental | $21.38 | $21.38 | $30.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | UE · Used equipment | $162.18 | $162.18 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $537.03 | Facility | None | $524.81 | $524.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $407.38 | Facility | None | $269.15 | $269.15 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $1,819.70 | Professional | None | $199.53 | $269.15 | $1,819.70 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $501.19 | Professional | None | $251.19 | $331.13 | $501.19 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $173.78 | Facility | None | $158.49 | $158.49 | $173.78 |
United Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $338.84 | Professional | None | $112.20 | $199.53 | $338.84 |
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 $95.50 Median $95.50 Typical High $177.83 | Professional | 52 · Reduced service | $95.50 | $95.50 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $72.44 | Professional | 53 · Discontinued | $38.02 | $38.02 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $53.70 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $36.31 |
Where Indiana sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 37th of 51
$219
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.