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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,148.15 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $2,630.27 | Facility | None | $1,949.84 | $2,454.71 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,122.02 | $2,454.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | RR · Rental | $112.20 | $112.20 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | UE · Used equipment | $851.14 | $851.14 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,818.38 | Facility | None | $2,691.53 | $2,691.53 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,454.71 | Facility | None | $1,174.90 | $1,174.90 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $10,232.93 | Professional | None | $851.14 | $1,174.90 | $10,232.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $7,413.10 | Facility | None | $912.01 | $2,089.30 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,995.26 | $2,951.21 |
United Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $933.25 | Facility | None | $741.31 | $741.31 | $933.25 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,995.26 | Professional | None | $616.60 | $1,202.26 | $1,995.26 |
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 $575.44 Median $575.44 Typical High $933.25 | Professional | 52 · Reduced service | $575.44 | $575.44 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $371.54 | Professional | 53 · Discontinued | $229.09 | $229.09 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $281.84 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $186.21 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $186.21 |
Where Indiana sits
The same service costs 3.0 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· 36th of 51
$1,148
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.