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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,995.26 | $1,995.26 | $3,890.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $4,265.80 Typical High $4,570.88 | Facility | None | $3,388.44 | $4,265.80 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $4,265.80 | Professional | None | $2,238.72 | $2,238.72 | $4,265.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $223.87 Median $223.87 Typical High $323.59 | Professional | RR · Rental | $223.87 | $223.87 | $323.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,698.24 Median $1,698.24 Typical High $2,398.83 | Professional | UE · Used equipment | $1,698.24 | $1,698.24 | $2,398.83 |
CareSource Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,888.44 | Facility | None | $5,623.41 | $5,623.41 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,265.80 | Facility | None | $2,951.21 | $2,951.21 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $19,952.62 | Professional | None | $2,187.76 | $2,951.21 | $19,952.62 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $12,882.50 | Facility | None | $912.01 | $2,089.30 | $12,882.50 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,630.27 Median $3,467.37 Typical High $5,248.07 | Professional | None | $2,630.27 | $3,467.37 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,951.21 | Facility | None | $2,041.74 | $2,041.74 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,230.27 | $2,089.30 | $3,467.37 |
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 $1,000.00 Median $1,000.00 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $776.25 | Professional | 53 · Discontinued | $398.11 | $398.11 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $588.84 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $389.05 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $389.05 |
Where Indiana sits
The same service costs 2.5 times more in Montana than in Washington, DC. 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· 40th of 51
$2,239
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.