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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,096.48 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $2,454.71 | Facility | None | $1,819.70 | $2,344.23 | $2,454.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,047.13 | $2,344.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $104.71 Median $104.71 Typical High $147.91 | Professional | RR · Rental | $104.71 | $104.71 | $147.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $794.33 Median $794.33 Typical High $1,096.48 | Professional | UE · Used equipment | $794.33 | $794.33 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,754.23 | Facility | None | $2,630.27 | $2,630.27 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,344.23 | Facility | None | $1,479.11 | $1,479.11 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $9,772.37 | Professional | None | $1,071.52 | $1,479.11 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $7,079.46 | Facility | None | $912.01 | $2,089.30 | $7,079.46 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,905.46 | $2,818.38 |
United Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Facility | None | $954.99 | $954.99 | $1,148.15 |
United Setting Professional Modifier None Typical Low $575.44 Median $1,148.15 Typical High $1,905.46 | Professional | None | $575.44 | $1,148.15 | $1,905.46 |
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 $537.03 Median $537.03 Typical High $912.01 | Professional | 52 · Reduced service | $537.03 | $537.03 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $363.08 | Professional | 53 · Discontinued | $218.78 | $218.78 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $275.42 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $181.97 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $181.97 |
Where Indiana sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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
$1,096
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.