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 $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,348.96 | Professional | None | $645.65 | $645.65 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,445.44 | Facility | None | $1,096.48 | $1,380.38 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,380.38 | Professional | None | $812.83 | $812.83 | $1,380.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | RR · Rental | $81.28 | $81.28 | $117.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $616.60 Typical High $870.96 | Professional | UE · Used equipment | $616.60 | $616.60 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,041.74 | Facility | None | $1,949.84 | $1,949.84 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,380.38 | Facility | None | $870.96 | $870.96 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $7,762.47 | Professional | None | $630.96 | $870.96 | $7,762.47 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,041.74 Typical High $4,168.69 | Facility | None | $912.01 | $2,041.74 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,659.59 | Professional | None | $851.14 | $1,122.02 | $1,659.59 |
United Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,513.56 | Facility | None | $891.25 | $891.25 | $1,513.56 |
United Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,122.02 | Professional | None | $446.68 | $676.08 | $1,122.02 |
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 $323.59 Median $323.59 Typical High $676.08 | Professional | 52 · Reduced service | $323.59 | $323.59 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $269.15 | Professional | 53 · Discontinued | $128.82 | $128.82 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $204.17 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $134.90 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $134.90 |
Where Indiana sits
The same service costs 4.0 times more in Hawaii 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· 37th of 51
$813
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.