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 $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $12,882.50 | Professional | None | $6,606.93 | $6,606.93 | $12,882.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,220.18 Median $14,454.40 Typical High $15,135.61 | Facility | None | $11,220.18 | $14,454.40 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $14,454.40 | Professional | None | $7,413.10 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $741.31 Median $741.31 Typical High $1,047.13 | Professional | RR · Rental | $741.31 | $741.31 | $1,047.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5,623.41 Median $5,623.41 Typical High $7,585.78 | Professional | UE · Used equipment | $5,623.41 | $5,623.41 | $7,585.78 |
CareSource Setting Facility Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $19,498.45 | Facility | None | $18,620.87 | $18,620.87 | $19,498.45 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $14,454.40 | Facility | None | $9,120.11 | $9,120.11 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $9,120.11 Typical High $66,069.34 | Professional | None | $6,606.93 | $9,120.11 | $66,069.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $20,892.96 Typical High $44,668.36 | Facility | None | $912.01 | $20,892.96 | $44,668.36 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $8,912.51 Median $11,748.98 Typical High $19,952.62 | Professional | None | $8,912.51 | $11,748.98 | $19,952.62 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Facility | None | $5,128.61 | $5,128.61 | $6,165.95 |
United Setting Professional Modifier None Typical Low $4,073.80 Median $7,079.46 Typical High $11,748.98 | Professional | None | $4,073.80 | $7,079.46 | $11,748.98 |
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 $3,311.31 Median $3,311.31 Typical High $6,456.54 | Professional | 52 · Reduced service | $3,311.31 | $3,311.31 | $6,456.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,348.96 Median $1,348.96 Typical High $2,570.40 | Professional | 53 · Discontinued | $1,348.96 | $1,348.96 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,000.00 Median $1,000.00 Typical High $1,949.84 | Professional | 55 · Aftercare only | $1,000.00 | $1,000.00 | $1,949.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $660.69 Median $660.69 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $660.69 | $660.69 | $1,288.25 |
Where Indiana sits
The same service costs 2.5 times more in Montana 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· 36th of 51
$7,413
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.