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 $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,630.78 | Professional | None | $1,949.84 | $1,949.84 | $3,630.78 |
Ambetter Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $4,168.69 Typical High $4,466.84 | Facility | None | $3,311.31 | $4,168.69 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $4,168.69 | Professional | None | $2,137.96 | $2,187.76 | $4,168.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $213.80 Median $213.80 Typical High $302.00 | Professional | RR · Rental | $213.80 | $213.80 | $302.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,621.81 Median $1,621.81 Typical High $2,238.72 | Professional | UE · Used equipment | $1,621.81 | $1,621.81 | $2,238.72 |
CareSource Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,370.32 | Facility | None | $5,248.07 | $5,248.07 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,168.69 | Facility | None | $2,137.96 | $2,137.96 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $19,054.61 | Professional | None | $1,584.89 | $2,137.96 | $19,054.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $12,589.25 | Facility | None | $912.01 | $2,089.30 | $12,589.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,570.40 Median $3,388.44 Typical High $5,128.61 | Professional | None | $2,570.40 | $3,388.44 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,148.15 | $2,041.74 | $3,388.44 |
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 $977.24 Median $977.24 Typical High $1,778.28 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $724.44 | Professional | 53 · Discontinued | $389.05 | $389.05 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $537.03 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $363.08 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $363.08 |
Where Indiana sits
The same service costs 2.6 times more in Wisconsin 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· 34th of 51
$2,138
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.