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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $213.80 | Professional | None | $117.49 | $117.49 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $257.04 Typical High $269.15 | Facility | None | $199.53 | $257.04 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $257.04 | Professional | None | $125.89 | $125.89 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $18.20 | Professional | RR · Rental | $12.59 | $12.59 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $95.50 Typical High $131.83 | Professional | UE · Used equipment | $95.50 | $95.50 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $316.23 | Facility | None | $309.03 | $309.03 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $257.04 | Facility | None | $165.96 | $165.96 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $1,174.90 | Professional | None | $120.23 | $165.96 | $1,174.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $616.60 Median $912.01 Typical High $2,137.96 | Facility | None | $616.60 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $309.03 | Professional | None | $158.49 | $208.93 | $309.03 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Facility | None | $138.04 | $138.04 | $141.25 |
United Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $208.93 | Professional | None | $70.79 | $123.03 | $208.93 |
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 $58.88 Median $58.88 Typical High $104.71 | Professional | 52 · Reduced service | $58.88 | $58.88 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $42.66 | Professional | 53 · Discontinued | $23.99 | $23.99 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $31.62 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $21.38 |
Where Indiana sits
The same service costs 2.8 times more in Hawaii than in Florida. 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
$126
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.