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 $8,709.64 Median $8,709.64 Typical High $8,709.64 | Facility | None | $8,709.64 | $8,709.64 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $17,378.01 | Professional | None | $8,709.64 | $8,709.64 | $17,378.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $14,454.40 Median $18,620.87 Typical High $19,498.45 | Facility | None | $14,454.40 | $18,620.87 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $18,620.87 | Professional | None | $10,232.93 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,023.29 Median $1,023.29 Typical High $1,479.11 | Professional | RR · Rental | $1,023.29 | $1,023.29 | $1,479.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,762.47 Median $7,762.47 Typical High $10,964.78 | Professional | UE · Used equipment | $7,762.47 | $7,762.47 | $10,964.78 |
CareSource Setting Facility Modifier None Typical Low $25,118.86 Median $25,118.86 Typical High $25,703.96 | Facility | None | $25,118.86 | $25,118.86 | $25,703.96 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $18,620.87 | Facility | None | $11,748.98 | $11,748.98 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $8,511.38 Median $11,748.98 Typical High $91,201.08 | Professional | None | $8,511.38 | $11,748.98 | $91,201.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $26,915.35 Typical High $57,543.99 | Facility | None | $912.01 | $26,915.35 | $57,543.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $11,481.54 Median $15,135.61 Typical High $25,703.96 | Professional | None | $11,481.54 | $15,135.61 | $25,703.96 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,912.51 | Facility | None | $7,585.78 | $7,585.78 | $8,912.51 |
United Setting Professional Modifier None Typical Low $5,623.41 Median $9,120.11 Typical High $15,135.61 | Professional | None | $5,623.41 | $9,120.11 | $15,135.61 |
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 $4,365.16 Median $4,365.16 Typical High $8,709.64 | Professional | 52 · Reduced service | $4,365.16 | $4,365.16 | $8,709.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,737.80 Median $1,737.80 Typical High $3,467.37 | Professional | 53 · Discontinued | $1,737.80 | $1,737.80 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,288.25 Median $1,288.25 Typical High $2,570.40 | Professional | 55 · Aftercare only | $1,288.25 | $1,288.25 | $2,570.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $870.96 Median $870.96 Typical High $1,737.80 | Professional | 56 · Pre-op care only | $870.96 | $870.96 | $1,737.80 |
Where Indiana sits
The same service costs 2.6 times more in Montana than in New Jersey. 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
$10,233
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.