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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $204.17 | Professional | None | $114.82 | $114.82 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $245.47 Typical High $263.03 | Facility | None | $194.98 | $245.47 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $245.47 | Professional | None | $123.03 | $123.03 | $245.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $17.38 | Professional | RR · Rental | $12.30 | $12.30 | $17.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | UE · Used equipment | $93.33 | $93.33 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $309.03 | Facility | None | $295.12 | $295.12 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $245.47 | Facility | None | $169.82 | $169.82 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $1,202.26 | Professional | None | $123.03 | $169.82 | $1,202.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $2,187.76 | Facility | None | $371.54 | $776.25 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $346.74 | Professional | None | $154.88 | $204.17 | $346.74 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Facility | None | $107.15 | $107.15 | $134.90 |
United Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $199.53 | Professional | None | $67.61 | $120.23 | $199.53 |
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 $57.54 Median $57.54 Typical High $102.33 | Professional | 52 · Reduced service | $57.54 | $57.54 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $40.74 | Professional | 53 · Discontinued | $22.91 | $22.91 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $30.90 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $20.42 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $20.42 |
Where Indiana sits
The same service costs 2.7 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· 44th of 51
$123
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.