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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $645.65 | Professional | None | $363.08 | $363.08 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $776.25 Typical High $812.83 | Facility | None | $602.56 | $776.25 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $776.25 | Professional | None | $380.19 | $380.19 | $776.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | RR · Rental | $38.02 | $38.02 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $288.40 Typical High $407.38 | Professional | UE · Used equipment | $288.40 | $288.40 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $954.99 | Facility | None | $933.25 | $933.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $776.25 | Facility | None | $398.11 | $398.11 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $3,467.37 | Professional | None | $288.40 | $398.11 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,344.23 | Facility | None | $912.01 | $1,122.02 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $933.25 | Professional | None | $478.63 | $630.96 | $933.25 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $630.96 | Professional | None | $208.93 | $380.19 | $630.96 |
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 $177.83 Median $177.83 Typical High $323.59 | Professional | 52 · Reduced service | $177.83 | $177.83 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $128.82 | Professional | 53 · Discontinued | $72.44 | $72.44 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $95.50 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $64.57 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $64.57 |
Where Indiana sits
The same service costs 2.8 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· 38th of 51
$380
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.