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 $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $10,964.78 | Professional | None | $5,128.61 | $5,128.61 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,709.64 Median $10,964.78 Typical High $11,748.98 | Facility | None | $8,709.64 | $10,964.78 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $10,964.78 | Professional | None | $6,606.93 | $6,606.93 | $10,964.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $660.69 Median $660.69 Typical High $933.25 | Professional | RR · Rental | $660.69 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,897.79 Median $4,897.79 Typical High $6,918.31 | Professional | UE · Used equipment | $4,897.79 | $4,897.79 | $6,918.31 |
CareSource Setting Facility Modifier None Typical Low $15,848.93 Median $15,848.93 Typical High $16,595.87 | Facility | None | $15,848.93 | $15,848.93 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $10,964.78 | Facility | None | $7,585.78 | $7,585.78 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $7,585.78 Typical High $51,286.14 | Professional | None | $5,495.41 | $7,585.78 | $51,286.14 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $16,218.10 Typical High $33,884.42 | Facility | None | $912.01 | $16,218.10 | $33,884.42 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $6,918.31 Median $9,120.11 Typical High $15,488.17 | Professional | None | $6,918.31 | $9,120.11 | $15,488.17 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,786.30 | Facility | None | $4,265.80 | $4,265.80 | $4,786.30 |
United Setting Professional Modifier None Typical Low $3,162.28 Median $5,370.32 Typical High $8,912.51 | Professional | None | $3,162.28 | $5,370.32 | $8,912.51 |
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 $2,570.40 Median $2,570.40 Typical High $5,495.41 | Professional | 52 · Reduced service | $2,570.40 | $2,570.40 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,023.29 Typical High $2,187.76 | Professional | 53 · Discontinued | $1,023.29 | $1,023.29 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $776.25 Typical High $1,659.59 | Professional | 55 · Aftercare only | $776.25 | $776.25 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $512.86 Median $512.86 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $512.86 | $512.86 | $1,096.48 |
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· 34th of 51
$6,607
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.