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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $199.53 | Professional | None | $93.33 | $93.33 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $213.80 | Facility | None | $158.49 | $199.53 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $199.53 | Professional | None | $120.23 | $120.23 | $199.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $16.98 | Professional | RR · Rental | $12.02 | $12.02 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $128.82 | Professional | UE · Used equipment | $89.13 | $89.13 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $302.00 | Facility | None | $288.40 | $288.40 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $199.53 | Facility | None | $123.03 | $123.03 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $1,096.48 | Professional | None | $89.13 | $123.03 | $1,096.48 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $2,137.96 | Facility | None | $489.78 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $245.47 | Professional | None | $125.89 | $165.96 | $245.47 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
United Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $162.18 | Professional | None | $64.57 | $97.72 | $162.18 |
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 $46.77 Median $46.77 Typical High $100.00 | Professional | 52 · Reduced service | $46.77 | $46.77 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $39.81 | Professional | 53 · Discontinued | $18.62 | $18.62 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $30.20 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $19.95 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $19.95 |
Where Indiana sits
The same service costs 3.0 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· 41st of 51
$120
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.