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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $537.03 | Professional | None | $316.23 | $316.23 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $724.44 | Facility | None | $537.03 | $676.08 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $676.08 | Professional | None | $323.59 | $323.59 | $676.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $45.71 | Professional | RR · Rental | $32.36 | $32.36 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $346.74 | Professional | UE · Used equipment | $239.88 | $239.88 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $812.83 | Facility | None | $776.25 | $776.25 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $676.08 | Facility | None | $398.11 | $398.11 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $2,951.21 | Professional | None | $288.40 | $398.11 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,000.00 Typical High $2,137.96 | Facility | None | $912.01 | $1,000.00 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $812.83 | Professional | None | $416.87 | $549.54 | $812.83 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $549.54 | Professional | None | $177.83 | $331.13 | $549.54 |
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 $158.49 Median $158.49 Typical High $269.15 | Professional | 52 · Reduced service | $158.49 | $158.49 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $107.15 | Professional | 53 · Discontinued | $63.10 | $63.10 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $81.28 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $53.70 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $53.70 |
Where Indiana sits
The same service costs 2.6 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· 33rd of 51
$331
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.