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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $912.01 | Professional | None | $467.74 | $467.74 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,047.13 | Facility | None | $794.33 | $1,000.00 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,000.00 | Professional | None | $457.09 | $457.09 | $1,000.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | RR · Rental | $45.71 | $45.71 | $64.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $478.63 | Professional | UE · Used equipment | $346.74 | $346.74 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Facility | None | $1,318.26 | $1,318.26 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $1,000.00 | Facility | None | $645.65 | $645.65 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $4,265.80 | Professional | None | $467.74 | $645.65 | $4,265.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $3,019.95 | Facility | None | $912.01 | $1,479.11 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Professional | None | $616.60 | $812.83 | $1,202.26 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $251.19 Median $489.78 Typical High $812.83 | Professional | None | $251.19 | $489.78 | $812.83 |
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 $234.42 Median $234.42 Typical High $457.09 | Professional | 52 · Reduced service | $234.42 | $234.42 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $181.97 | Professional | 53 · Discontinued | $93.33 | $93.33 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $138.04 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $91.20 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $91.20 |
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· 40th of 51
$468
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.