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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,148.15 | Professional | None | $660.69 | $660.69 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,513.56 | Facility | None | $1,122.02 | $1,412.54 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,412.54 | Professional | None | $691.83 | $691.83 | $1,412.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $100.00 | Professional | RR · Rental | $69.18 | $69.18 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $524.81 Median $524.81 Typical High $741.31 | Professional | UE · Used equipment | $524.81 | $524.81 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,737.80 | Facility | None | $1,659.59 | $1,659.59 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,412.54 | Facility | None | $933.25 | $933.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $6,456.54 | Professional | None | $676.08 | $933.25 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $4,265.80 | Facility | None | $912.01 | $2,089.30 | $4,265.80 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,737.80 | Professional | None | $870.96 | $1,148.15 | $1,737.80 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $575.44 | Facility | None | $478.63 | $478.63 | $575.44 |
United Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $1,148.15 | Professional | None | $389.05 | $691.83 | $1,148.15 |
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 $331.13 Median $331.13 Typical High $575.44 | Professional | 52 · Reduced service | $331.13 | $331.13 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $229.09 | Professional | 53 · Discontinued | $131.83 | $131.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $173.78 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $114.82 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $114.82 |
Where Indiana sits
The same service costs 2.1 times more in Wisconsin than in Washington, DC. 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
$692
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.