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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $891.25 | Professional | None | $512.86 | $512.86 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,174.90 | Facility | None | $870.96 | $1,096.48 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,096.48 | Professional | None | $501.19 | $501.19 | $1,096.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | RR · Rental | $50.12 | $50.12 | $70.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $380.19 Median $380.19 Typical High $562.34 | Professional | UE · Used equipment | $380.19 | $380.19 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,348.96 | Facility | None | $1,288.25 | $1,288.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $1,096.48 | Facility | None | $691.83 | $691.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $4,677.35 | Professional | None | $512.86 | $691.83 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,621.81 Typical High $3,311.31 | Facility | None | $912.01 | $1,621.81 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,318.26 | Professional | None | $676.08 | $891.25 | $1,318.26 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $501.19 | Facility | None | $398.11 | $398.11 | $501.19 |
United Setting Professional Modifier None Typical Low $275.42 Median $537.03 Typical High $891.25 | Professional | None | $275.42 | $537.03 | $891.25 |
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 $257.04 Median $257.04 Typical High $446.68 | Professional | 52 · Reduced service | $257.04 | $257.04 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $177.83 | Professional | 53 · Discontinued | $102.33 | $102.33 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $134.90 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $89.13 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $89.13 |
Where Indiana sits
The same service costs 2.4 times more in Hawaii than in Washington, DC. 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
$513
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.