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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,288.25 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $2,951.21 | Facility | None | $2,187.76 | $2,754.23 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,380.38 | $2,754.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $138.04 Typical High $194.98 | Professional | RR · Rental | $138.04 | $138.04 | $194.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $1,047.13 Typical High $1,479.11 | Professional | UE · Used equipment | $1,047.13 | $1,047.13 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,981.07 | Facility | None | $3,890.45 | $3,890.45 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,754.23 | Facility | None | $1,737.80 | $1,737.80 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $12,302.69 | Professional | None | $1,288.25 | $1,737.80 | $12,302.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $8,317.64 | Facility | None | $912.01 | $2,089.30 | $8,317.64 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,698.24 | $2,238.72 | $3,311.31 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Facility | None | $977.24 | $977.24 | $1,148.15 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,348.96 Typical High $2,238.72 | Professional | None | $758.58 | $1,348.96 | $2,238.72 |
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 $645.65 Median $645.65 Typical High $1,318.26 | Professional | 52 · Reduced service | $645.65 | $645.65 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $537.03 | Professional | 53 · Discontinued | $257.04 | $257.04 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $398.11 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $269.15 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $269.15 |
Where Indiana sits
The same service costs 2.1 times more in Montana 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
$1,380
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.