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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,122.02 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $2,511.89 | Facility | None | $1,905.46 | $2,398.83 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,096.48 | $2,398.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $158.49 | Professional | RR · Rental | $109.65 | $109.65 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $1,230.27 | Professional | UE · Used equipment | $831.76 | $831.76 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,235.94 | Facility | None | $3,090.30 | $3,090.30 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,398.83 | Facility | None | $1,122.02 | $1,122.02 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $10,232.93 | Professional | None | $831.76 | $1,122.02 | $10,232.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $7,244.36 | Facility | None | $912.01 | $2,089.30 | $7,244.36 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,949.84 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,047.13 | $1,047.13 | $1,202.26 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,174.90 Typical High $1,949.84 | Professional | None | $602.56 | $1,174.90 | $1,949.84 |
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 $562.34 Median $562.34 Typical High $1,071.52 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $426.58 | Professional | 53 · Discontinued | $223.87 | $223.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $323.59 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $213.80 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $213.80 |
Where Indiana sits
The same service costs 3.1 times more in Hawaii than in Delaware. 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· 37th of 51
$1,122
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.