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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $870.96 | Professional | None | $446.68 | $446.68 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $977.24 Typical High $1,023.29 | Facility | None | $758.58 | $977.24 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $977.24 | Professional | None | $537.03 | $537.03 | $977.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $75.86 | Professional | RR · Rental | $53.70 | $53.70 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $398.11 Median $398.11 Typical High $562.34 | Professional | UE · Used equipment | $398.11 | $398.11 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Facility | None | $1,258.93 | $1,258.93 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $977.24 | Facility | None | $616.60 | $616.60 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $5,011.87 | Professional | None | $446.68 | $616.60 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $2,951.21 | Facility | None | $912.01 | $1,412.54 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,174.90 | Professional | None | $602.56 | $794.33 | $1,174.90 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Facility | None | $588.84 | $588.84 | $707.95 |
United Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $794.33 | Professional | None | $288.40 | $467.74 | $794.33 |
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 $223.87 Median $223.87 Typical High $436.52 | Professional | 52 · Reduced service | $223.87 | $223.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $173.78 | Professional | 53 · Discontinued | $91.20 | $91.20 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $131.83 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $87.10 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $87.10 |
Where Indiana sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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
$537
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.