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 $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,570.40 | $2,570.40 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $5,623.41 Typical High $5,888.44 | Facility | None | $4,365.16 | $5,623.41 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $5,623.41 | Professional | None | $2,818.38 | $2,818.38 | $5,623.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $281.84 Median $281.84 Typical High $398.11 | Professional | RR · Rental | $281.84 | $281.84 | $398.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,089.30 Median $2,089.30 Typical High $2,951.21 | Professional | UE · Used equipment | $2,089.30 | $2,089.30 | $2,951.21 |
CareSource Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $7,079.46 | Facility | None | $6,760.83 | $6,760.83 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $5,623.41 | Facility | None | $3,548.13 | $3,548.13 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,548.13 Typical High $25,118.86 | Professional | None | $2,570.40 | $3,548.13 | $25,118.86 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $16,982.44 | Facility | None | $912.01 | $2,089.30 | $16,982.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,467.37 Median $4,570.88 Typical High $6,760.83 | Professional | None | $3,467.37 | $4,570.88 | $6,760.83 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,890.45 | Facility | None | $3,019.95 | $3,019.95 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $4,570.88 | Professional | None | $1,513.56 | $2,754.23 | $4,570.88 |
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 $1,288.25 Median $1,288.25 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $933.25 | Professional | 53 · Discontinued | $524.81 | $524.81 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $707.95 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $467.74 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $467.74 |
Where Indiana sits
The same service costs 3.0 times more in Hawaii than in Pennsylvania. 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· 39th of 51
$2,818
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.