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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $398.11 | Professional | None | $194.98 | $194.98 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $416.87 Typical High $436.52 | Facility | None | $331.13 | $416.87 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $416.87 | Professional | None | $204.17 | $204.17 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $28.84 | Professional | RR · Rental | $20.42 | $20.42 | $28.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $218.78 | Professional | UE · Used equipment | $154.88 | $154.88 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $602.56 | Facility | None | $575.44 | $575.44 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $416.87 | Facility | None | $245.47 | $245.47 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $1,819.70 | Professional | None | $177.83 | $245.47 | $1,819.70 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $501.19 | Professional | None | $257.04 | $338.84 | $501.19 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $173.78 | Facility | None | $169.82 | $169.82 | $173.78 |
United Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $338.84 | Professional | None | $112.20 | $204.17 | $338.84 |
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 $97.72 Median $97.72 Typical High $199.53 | Professional | 52 · Reduced service | $97.72 | $97.72 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $79.43 | Professional | 53 · Discontinued | $38.90 | $38.90 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $60.26 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $39.81 |
Where Indiana sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 38th of 51
$204
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.