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 $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $870.96 | Professional | None | $426.58 | $426.58 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $912.01 Typical High $977.24 | Facility | None | $724.44 | $912.01 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $912.01 | Professional | None | $524.81 | $524.81 | $912.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $74.13 | Professional | RR · Rental | $52.48 | $52.48 | $74.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $389.05 Median $389.05 Typical High $537.03 | Professional | UE · Used equipment | $389.05 | $389.05 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Facility | None | $1,258.93 | $1,258.93 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $912.01 | Facility | None | $588.84 | $588.84 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $4,677.35 | Professional | None | $426.58 | $588.84 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $2,754.23 | Facility | None | $912.01 | $1,348.96 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,122.02 | Professional | None | $562.34 | $741.31 | $1,122.02 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Facility | None | $501.19 | $501.19 | $524.81 |
United Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $741.31 | Professional | None | $288.40 | $446.68 | $741.31 |
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 $213.80 Median $213.80 Typical High $426.58 | Professional | 52 · Reduced service | $213.80 | $213.80 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $173.78 | Professional | 53 · Discontinued | $85.11 | $85.11 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $128.82 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $87.10 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $87.10 |
Where Indiana sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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
$525
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.