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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $691.83 | Professional | None | $331.13 | $331.13 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $707.95 Typical High $758.58 | Facility | None | $562.34 | $707.95 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $707.95 | Professional | None | $416.87 | $416.87 | $707.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | RR · Rental | $41.69 | $41.69 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | UE · Used equipment | $316.23 | $316.23 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Facility | None | $1,000.00 | $1,000.00 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $707.95 | Facility | None | $436.52 | $436.52 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $3,630.78 | Professional | None | $316.23 | $436.52 | $3,630.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,047.13 Typical High $2,187.76 | Facility | None | $912.01 | $1,047.13 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $851.14 | Professional | None | $436.52 | $575.44 | $851.14 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $346.74 | Facility | None | $257.04 | $257.04 | $346.74 |
United Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $575.44 | Professional | None | $229.09 | $346.74 | $575.44 |
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 $165.96 Median $165.96 Typical High $346.74 | Professional | 52 · Reduced service | $165.96 | $165.96 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $138.04 | Professional | 53 · Discontinued | $66.07 | $66.07 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $104.71 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $69.18 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $69.18 |
Where Indiana sits
The same service costs 2.8 times more in Montana 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· 33rd of 51
$417
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.