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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,148.15 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $2,630.27 | Facility | None | $1,949.84 | $2,454.71 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,380.38 | $2,454.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $138.04 Typical High $194.98 | Professional | RR · Rental | $138.04 | $138.04 | $194.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | UE · Used equipment | $1,023.29 | $1,023.29 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,388.44 | Facility | None | $3,311.31 | $3,311.31 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,454.71 | Facility | None | $1,659.59 | $1,659.59 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $12,882.50 | Professional | None | $1,202.26 | $1,659.59 | $12,882.50 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $7,413.10 | Facility | None | $912.01 | $2,089.30 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,995.26 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,513.56 | Facility | None | $1,202.26 | $1,202.26 | $1,513.56 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,995.26 | Professional | None | $758.58 | $1,202.26 | $1,995.26 |
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 $575.44 Median $575.44 Typical High $1,148.15 | Professional | 52 · Reduced service | $575.44 | $575.44 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $338.84 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $229.09 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $229.09 |
Where Indiana sits
The same service costs 3.5 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· 37th of 51
$1,380
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.