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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $758.58 | Professional | None | $446.68 | $446.68 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $1,023.29 | Facility | None | $758.58 | $954.99 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $954.99 | Professional | None | $457.09 | $478.63 | $954.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | RR · Rental | $45.71 | $45.71 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $489.78 | Professional | UE · Used equipment | $346.74 | $346.74 | $489.78 |
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 $660.69 Median $660.69 Typical High $954.99 | Facility | None | $660.69 | $660.69 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $4,265.80 | Professional | None | $489.78 | $660.69 | $4,265.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $2,884.03 | Facility | None | $912.01 | $1,412.54 | $2,884.03 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,148.15 | Professional | None | $588.84 | $776.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
United Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $776.25 | Professional | None | $251.19 | $467.74 | $776.25 |
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 $223.87 Median $223.87 Typical High $380.19 | Professional | 52 · Reduced service | $223.87 | $223.87 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $151.36 | Professional | 53 · Discontinued | $89.13 | $89.13 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $114.82 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $75.86 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $75.86 |
Where Indiana sits
The same service costs 4.1 times more in Hawaii than in Kansas. 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· 43rd of 51
$479
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.