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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $446.68 | Professional | None | $204.17 | $204.17 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $436.52 Typical High $467.74 | Facility | None | $346.74 | $436.52 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $436.52 | Professional | None | $269.15 | $269.15 | $436.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $38.02 | Professional | RR · Rental | $26.92 | $26.92 | $38.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $288.40 | Professional | UE · Used equipment | $199.53 | $199.53 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $676.08 | Facility | None | $645.65 | $645.65 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $436.52 | Facility | None | $281.84 | $281.84 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $2,454.71 | Professional | None | $204.17 | $281.84 | $2,454.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $537.03 | Professional | None | $269.15 | $354.81 | $537.03 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Facility | None | $288.40 | $288.40 | $389.05 |
United Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $363.08 | Professional | None | $144.54 | $213.80 | $363.08 |
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 $102.33 Median $102.33 Typical High $223.87 | Professional | 52 · Reduced service | $102.33 | $102.33 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $89.13 | Professional | 53 · Discontinued | $40.74 | $40.74 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $67.61 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $44.67 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $44.67 |
Where Indiana sits
The same service costs 4.1 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· 32nd of 51
$269
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.