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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $758.58 | Professional | None | $338.84 | $338.84 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $794.33 | Facility | None | $562.34 | $724.44 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | None | $457.09 | $457.09 | $724.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | RR · Rental | $45.71 | $45.71 | $64.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | UE · Used equipment | $338.84 | $338.84 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,148.15 | Facility | None | $1,096.48 | $1,096.48 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $724.44 | Facility | None | $446.68 | $446.68 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $3,890.45 | Professional | None | $331.13 | $446.68 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,047.13 Typical High $2,238.72 | Facility | None | $912.01 | $1,047.13 | $2,238.72 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $870.96 | Professional | None | $446.68 | $588.84 | $870.96 |
United Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
United Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $588.84 | Professional | None | $234.42 | $354.81 | $588.84 |
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 $165.96 Median $165.96 Typical High $380.19 | Professional | 52 · Reduced service | $165.96 | $165.96 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $151.36 | Professional | 53 · Discontinued | $67.61 | $67.61 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $114.82 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $75.86 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $75.86 |
Where Indiana sits
The same service costs 2.8 times more in Iowa 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· 28th of 51
$457
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.