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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $616.60 | Professional | None | $371.54 | $371.54 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $831.76 | Facility | None | $616.60 | $794.33 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $794.33 | Professional | None | $354.81 | $354.81 | $794.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $35.48 Typical High $50.12 | Professional | RR · Rental | $35.48 | $35.48 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $263.03 Median $263.03 Typical High $398.11 | Professional | UE · Used equipment | $263.03 | $263.03 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $912.01 | Facility | None | $891.25 | $891.25 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $794.33 | Facility | None | $501.19 | $501.19 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $3,235.94 | Professional | None | $363.08 | $501.19 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,398.83 | Facility | None | $912.01 | $1,148.15 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $954.99 | Professional | None | $489.78 | $645.65 | $954.99 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $288.40 | Facility | None | $229.09 | $229.09 | $288.40 |
United Setting Professional Modifier None Typical Low $190.55 Median $389.05 Typical High $645.65 | Professional | None | $190.55 | $389.05 | $645.65 |
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 $181.97 Median $181.97 Typical High $309.03 | Professional | 52 · Reduced service | $181.97 | $181.97 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $123.03 | Professional | 53 · Discontinued | $74.13 | $74.13 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $91.20 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $61.66 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $61.66 |
Where Indiana sits
The same service costs 2.3 times more in Wisconsin than in Florida. 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· 34th of 51
$372
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.