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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,412.54 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,235.94 | Facility | None | $2,398.83 | $3,019.95 | $3,235.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,698.24 | $1,778.28 | $3,019.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $169.82 Median $169.82 Typical High $239.88 | Professional | RR · Rental | $169.82 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $1,288.25 Typical High $1,737.80 | Professional | UE · Used equipment | $1,288.25 | $1,288.25 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,265.80 | Facility | None | $4,168.69 | $4,168.69 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $3,019.95 | Facility | None | $1,819.70 | $1,819.70 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $12,589.25 | Professional | None | $1,318.26 | $1,819.70 | $12,589.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $9,120.11 | Facility | None | $912.01 | $2,089.30 | $9,120.11 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $3,630.78 | Professional | None | $1,862.09 | $2,454.71 | $3,630.78 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,148.15 | Facility | None | $870.96 | $870.96 | $1,148.15 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,479.11 Typical High $2,454.71 | Professional | None | $758.58 | $1,479.11 | $2,454.71 |
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 $707.95 Median $707.95 Typical High $1,445.44 | Professional | 52 · Reduced service | $707.95 | $707.95 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $575.44 | Professional | 53 · Discontinued | $281.84 | $281.84 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $426.58 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $288.40 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $288.40 |
Where Indiana sits
The same service costs 2.3 times more in Wisconsin than in Pennsylvania. 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· 25th of 51
$1,698
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.