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 $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $7,943.28 | Professional | None | $4,786.30 | $4,786.30 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $10,232.93 Typical High $10,964.78 | Facility | None | $8,128.31 | $10,232.93 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $10,232.93 | Professional | None | $4,897.79 | $4,897.79 | $10,232.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $489.78 Typical High $691.83 | Professional | RR · Rental | $489.78 | $489.78 | $691.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $3,630.78 Typical High $5,011.87 | Professional | UE · Used equipment | $3,630.78 | $3,630.78 | $5,011.87 |
CareSource Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,022.64 | Facility | None | $11,748.98 | $11,748.98 | $12,022.64 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $10,232.93 | Facility | None | $6,606.93 | $6,606.93 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $6,606.93 Typical High $44,668.36 | Professional | None | $4,786.30 | $6,606.93 | $44,668.36 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $15,135.61 Typical High $32,359.37 | Facility | None | $912.01 | $15,135.61 | $32,359.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $6,456.54 Median $8,511.38 Typical High $14,454.40 | Professional | None | $6,456.54 | $8,511.38 | $14,454.40 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,466.84 | Facility | None | $3,801.89 | $3,801.89 | $4,466.84 |
United Setting Professional Modifier None Typical Low $2,691.53 Median $5,011.87 Typical High $8,317.64 | Professional | None | $2,691.53 | $5,011.87 | $8,317.64 |
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 $2,398.83 Median $2,398.83 Typical High $3,981.07 | Professional | 52 · Reduced service | $2,398.83 | $2,398.83 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $1,584.89 | Professional | 53 · Discontinued | $954.99 | $954.99 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $1,202.26 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $794.33 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $794.33 |
Where Indiana sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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
$4,898
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.