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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,380.38 | Professional | None | $758.58 | $758.58 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,737.80 | Facility | None | $1,288.25 | $1,621.81 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,621.81 | Professional | None | $831.76 | $831.76 | $1,621.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $120.23 | Professional | RR · Rental | $83.18 | $83.18 | $120.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $630.96 Median $630.96 Typical High $891.25 | Professional | UE · Used equipment | $630.96 | $630.96 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,041.74 | Facility | None | $1,995.26 | $1,995.26 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,047.13 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $7,413.10 | Professional | None | $758.58 | $1,047.13 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $4,897.79 | Facility | None | $912.01 | $2,089.30 | $4,897.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,318.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Facility | None | $912.01 | $912.01 | $1,000.00 |
United Setting Professional Modifier None Typical Low $457.09 Median $794.33 Typical High $1,318.26 | Professional | None | $457.09 | $794.33 | $1,318.26 |
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 $380.19 Median $380.19 Typical High $691.83 | Professional | 52 · Reduced service | $380.19 | $380.19 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $275.42 | Professional | 53 · Discontinued | $151.36 | $151.36 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $204.17 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $138.04 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $138.04 |
Where Indiana sits
The same service costs 3.1 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· 34th of 51
$832
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.