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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $281.84 | Professional | None | $131.83 | $131.83 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $302.00 | Facility | None | $223.87 | $288.40 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $288.40 | Professional | None | $169.82 | $169.82 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | RR · Rental | $16.98 | $16.98 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | UE · Used equipment | $128.82 | $128.82 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $416.87 | Facility | None | $407.38 | $407.38 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $288.40 | Facility | None | $173.78 | $173.78 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $1,621.81 | Professional | None | $128.82 | $173.78 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $691.83 Median $912.01 Typical High $2,137.96 | Facility | None | $691.83 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $346.74 | Professional | None | $177.83 | $234.42 | $346.74 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $229.09 | Facility | None | $186.21 | $186.21 | $229.09 |
United Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $234.42 | Professional | None | $93.33 | $138.04 | $234.42 |
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 $66.07 Median $66.07 Typical High $141.25 | Professional | 52 · Reduced service | $66.07 | $66.07 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $56.23 | Professional | 53 · Discontinued | $26.92 | $26.92 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $41.69 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $28.18 |
Where Indiana sits
The same service costs 4.0 times more in Hawaii than in Florida. 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· 42nd of 51
$170
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.