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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $691.83 | Professional | None | $363.08 | $363.08 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $776.25 Typical High $831.76 | Facility | None | $616.60 | $776.25 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $776.25 | Professional | None | $407.38 | $407.38 | $776.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $40.74 Median $40.74 Typical High $58.88 | Professional | RR · Rental | $40.74 | $40.74 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | UE · Used equipment | $309.03 | $309.03 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,023.29 | Facility | None | $1,000.00 | $1,000.00 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $776.25 | Facility | None | $524.81 | $524.81 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $3,548.13 | Professional | None | $389.05 | $524.81 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,344.23 | Facility | None | $912.01 | $1,148.15 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $954.99 | Professional | None | $478.63 | $630.96 | $954.99 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $380.19 | Facility | None | $302.00 | $302.00 | $380.19 |
United Setting Professional Modifier None Typical Low $213.80 Median $380.19 Typical High $630.96 | Professional | None | $213.80 | $380.19 | $630.96 |
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 $181.97 Median $181.97 Typical High $346.74 | Professional | 52 · Reduced service | $181.97 | $181.97 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $138.04 | Professional | 53 · Discontinued | $72.44 | $72.44 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $102.33 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $69.18 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $69.18 |
Where Indiana sits
The same service costs 2.3 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· 33rd of 51
$407
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.