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 $229.09 | Professional | None | $117.49 | $117.49 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $251.19 Typical High $269.15 | Facility | None | $199.53 | $251.19 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $251.19 | Professional | None | $138.04 | $138.04 | $251.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $19.50 | Professional | RR · Rental | $13.80 | $13.80 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | UE · Used equipment | $102.33 | $102.33 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $346.74 | Facility | None | $338.84 | $338.84 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $251.19 | Facility | None | $158.49 | $158.49 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $1,202.26 | Professional | None | $117.49 | $158.49 | $1,202.26 |
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 $302.00 | Professional | None | $158.49 | $208.93 | $302.00 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
United Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $204.17 | Professional | None | $74.13 | $123.03 | $204.17 |
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 $114.82 | Professional | 52 · Reduced service | $58.88 | $58.88 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $46.77 | Professional | 53 · Discontinued | $23.44 | $23.44 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $34.67 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $22.91 |
Where Indiana sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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
$138
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.