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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $794.33 | Professional | None | $416.87 | $416.87 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $954.99 | Facility | None | $707.95 | $891.25 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $891.25 | Professional | None | $478.63 | $478.63 | $891.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $69.18 | Professional | RR · Rental | $47.86 | $47.86 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $512.86 | Professional | UE · Used equipment | $363.08 | $363.08 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,174.90 | Facility | None | $1,148.15 | $1,148.15 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $891.25 | Facility | None | $588.84 | $588.84 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $4,168.69 | Professional | None | $426.58 | $588.84 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,318.26 Typical High $2,691.53 | Facility | None | $912.01 | $1,318.26 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,096.48 | Professional | None | $549.54 | $724.44 | $1,096.48 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
United Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $724.44 | Professional | None | $263.03 | $436.52 | $724.44 |
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 $208.93 Median $208.93 Typical High $398.11 | Professional | 52 · Reduced service | $208.93 | $208.93 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $158.49 | Professional | 53 · Discontinued | $83.18 | $83.18 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $117.49 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $79.43 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $79.43 |
Where Indiana sits
The same service costs 2.5 times more in Montana than in Alabama. 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· 35th of 51
$479
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.