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 $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,445.44 | Professional | None | $812.83 | $812.83 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,862.09 | Facility | None | $1,380.38 | $1,737.80 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,737.80 | Professional | None | $870.96 | $891.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | RR · Rental | $87.10 | $87.10 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | UE · Used equipment | $660.69 | $660.69 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,137.96 | Facility | None | $2,089.30 | $2,089.30 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,737.80 | Facility | None | $1,202.26 | $1,202.26 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $7,943.28 | Professional | None | $870.96 | $1,202.26 | $7,943.28 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $5,248.07 | Facility | None | $912.01 | $2,089.30 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,412.54 | $2,137.96 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Facility | None | $457.09 | $457.09 | $724.44 |
United Setting Professional Modifier None Typical Low $478.63 Median $851.14 Typical High $1,412.54 | Professional | None | $478.63 | $851.14 | $1,412.54 |
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 $407.38 Median $407.38 Typical High $724.44 | Professional | 52 · Reduced service | $407.38 | $407.38 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $288.40 | Professional | 53 · Discontinued | $162.18 | $162.18 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $213.80 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $144.54 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $144.54 |
Where Indiana sits
The same service costs 2.6 times more in Montana than in Florida. 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
$891
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.