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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $524.81 | Professional | None | $245.47 | $245.47 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $524.81 Typical High $562.34 | Facility | None | $416.87 | $524.81 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $524.81 | Professional | None | $316.23 | $316.23 | $524.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $31.62 Median $31.62 Typical High $44.67 | Professional | RR · Rental | $31.62 | $31.62 | $44.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $234.42 Median $234.42 Typical High $338.84 | Professional | UE · Used equipment | $234.42 | $234.42 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $794.33 | Facility | None | $758.58 | $758.58 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $524.81 | Facility | None | $363.08 | $363.08 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $2,884.03 | Professional | None | $263.03 | $363.08 | $2,884.03 |
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 $323.59 Median $426.58 Typical High $630.96 | Professional | None | $323.59 | $426.58 | $630.96 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $416.87 | Facility | None | $346.74 | $346.74 | $416.87 |
United Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $426.58 | Professional | None | $173.78 | $257.04 | $426.58 |
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 $123.03 Median $123.03 Typical High $263.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $104.71 | Professional | 53 · Discontinued | $48.98 | $48.98 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $79.43 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $52.48 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $52.48 |
Where Indiana sits
The same service costs 3.7 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· 39th of 51
$316
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.