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 $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $5,248.07 | Professional | None | $2,754.23 | $2,754.23 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $5,888.44 Typical High $6,309.57 | Facility | None | $4,677.35 | $5,888.44 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $5,888.44 | Professional | None | $3,162.28 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | RR · Rental | $316.23 | $316.23 | $446.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,398.83 Median $2,398.83 Typical High $3,388.44 | Professional | UE · Used equipment | $2,398.83 | $2,398.83 | $3,388.44 |
CareSource Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,762.47 | Facility | None | $7,585.78 | $7,585.78 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,888.44 | Facility | None | $3,715.35 | $3,715.35 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $3,715.35 Typical High $28,840.32 | Professional | None | $2,754.23 | $3,715.35 | $28,840.32 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $17,782.79 | Facility | None | $912.01 | $2,089.30 | $17,782.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,630.78 Median $4,786.30 Typical High $7,079.46 | Professional | None | $3,630.78 | $4,786.30 | $7,079.46 |
United Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,884.03 Typical High $4,786.30 | Professional | None | $1,737.80 | $2,884.03 | $4,786.30 |
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 $1,380.38 Median $1,380.38 Typical High $2,630.27 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $1,047.13 | Professional | 53 · Discontinued | $549.54 | $549.54 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $776.25 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $524.81 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $524.81 |
Where Indiana sits
The same service costs 2.9 times more in Hawaii 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· 39th of 51
$3,162
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.