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 $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $18,197.01 | Professional | None | $9,332.54 | $9,332.54 | $18,197.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,488.17 Median $19,952.62 Typical High $20,892.96 | Facility | None | $15,488.17 | $19,952.62 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $19,952.62 | Professional | None | $10,715.19 | $10,715.19 | $19,952.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,071.52 Median $1,071.52 Typical High $1,513.56 | Professional | RR · Rental | $1,071.52 | $1,071.52 | $1,513.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,943.28 Median $7,943.28 Typical High $10,964.78 | Professional | UE · Used equipment | $7,943.28 | $7,943.28 | $10,964.78 |
CareSource Setting Facility Modifier None Typical Low $26,302.68 Median $26,302.68 Typical High $26,915.35 | Facility | None | $26,302.68 | $26,302.68 | $26,915.35 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $19,952.62 | Facility | None | $12,589.25 | $12,589.25 | $19,952.62 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $12,589.25 Typical High $95,499.26 | Professional | None | $9,120.11 | $12,589.25 | $95,499.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $28,840.32 Typical High $61,659.50 | Facility | None | $912.01 | $28,840.32 | $61,659.50 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $12,302.69 Median $16,218.10 Typical High $27,542.29 | Professional | None | $12,302.69 | $16,218.10 | $27,542.29 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $9,332.54 | Facility | None | $7,943.28 | $7,943.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $5,888.44 Median $9,772.37 Typical High $16,218.10 | Professional | None | $5,888.44 | $9,772.37 | $16,218.10 |
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 $4,570.88 Median $4,570.88 Typical High $9,120.11 | Professional | 52 · Reduced service | $4,570.88 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,862.09 Median $1,862.09 Typical High $3,630.78 | Professional | 53 · Discontinued | $1,862.09 | $1,862.09 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,380.38 Median $1,380.38 Typical High $2,691.53 | Professional | 55 · Aftercare only | $1,380.38 | $1,380.38 | $2,691.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $933.25 Median $933.25 Typical High $1,819.70 | Professional | 56 · Pre-op care only | $933.25 | $933.25 | $1,819.70 |
Where Indiana sits
The same service costs 2.5 times more in Montana than in Florida. 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
$10,715
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.