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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,148.15 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $2,630.27 | Facility | None | $1,949.84 | $2,454.71 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,445.44 | $2,454.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $144.54 Median $144.54 Typical High $204.17 | Professional | RR · Rental | $144.54 | $144.54 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,096.48 Median $1,096.48 Typical High $1,548.82 | Professional | UE · Used equipment | $1,096.48 | $1,096.48 | $1,548.82 |
CareSource Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,630.78 | Facility | None | $3,548.13 | $3,548.13 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,454.71 | Facility | None | $1,348.96 | $1,348.96 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $11,748.98 | Professional | None | $977.24 | $1,348.96 | $11,748.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $7,585.78 | Facility | None | $912.01 | $3,630.78 | $7,585.78 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,548.82 | $2,041.74 | $3,467.37 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,995.26 | Professional | None | $724.44 | $1,202.26 | $1,995.26 |
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 $575.44 Median $575.44 Typical High $1,202.26 | Professional | 52 · Reduced service | $575.44 | $575.44 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $489.78 | Professional | 53 · Discontinued | $229.09 | $229.09 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $363.08 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $239.88 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $239.88 |
Where Indiana sits
The same service costs 2.6 times more in Montana 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
$1,445
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.