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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $295.12 | Professional | None | $154.88 | $154.88 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $331.13 Typical High $354.81 | Facility | None | $263.03 | $331.13 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $331.13 | Professional | None | $177.83 | $181.97 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $25.12 | Professional | RR · Rental | $17.78 | $17.78 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | UE · Used equipment | $131.83 | $131.83 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $436.52 | Facility | None | $426.58 | $426.58 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $331.13 | Facility | None | $165.96 | $165.96 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $1,445.44 | Professional | None | $120.23 | $165.96 | $1,445.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $2,137.96 | Facility | None | $812.83 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $398.11 | Professional | None | $208.93 | $269.15 | $398.11 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Facility | None | $134.90 | $134.90 | $141.25 |
United Setting Professional Modifier None Typical Low $89.13 Median $162.18 Typical High $269.15 | Professional | None | $89.13 | $162.18 | $269.15 |
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 $77.62 Median $77.62 Typical High $147.91 | Professional | 52 · Reduced service | $77.62 | $77.62 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $58.88 | Professional | 53 · Discontinued | $30.90 | $30.90 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $43.65 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $29.51 |
Where Indiana sits
The same service costs 2.8 times more in Montana 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· 29th of 51
$178
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.