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 $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $8,912.51 | Professional | None | $3,467.37 | $3,467.37 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $7,413.10 Typical High $7,943.28 | Facility | None | $5,888.44 | $7,413.10 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,413.10 | Professional | None | $4,265.80 | $4,265.80 | $7,413.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $426.58 Median $426.58 Typical High $602.56 | Professional | RR · Rental | $426.58 | $426.58 | $602.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,235.94 Median $3,235.94 Typical High $4,466.84 | Professional | UE · Used equipment | $3,235.94 | $3,235.94 | $4,466.84 |
CareSource Setting Facility Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $13,489.63 | Facility | None | $12,882.50 | $12,882.50 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $7,413.10 | Facility | None | $4,677.35 | $4,677.35 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $37,153.52 | Professional | None | $3,467.37 | $4,677.35 | $37,153.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $10,964.78 Typical High $22,908.68 | Facility | None | $912.01 | $10,964.78 | $22,908.68 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $4,677.35 Median $6,165.95 Typical High $10,471.29 | Professional | None | $4,677.35 | $6,165.95 | $10,471.29 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,548.13 | Facility | None | $2,884.03 | $2,884.03 | $3,548.13 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $6,025.60 | Professional | None | $2,344.23 | $3,630.78 | $6,025.60 |
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 $1,737.80 Median $1,737.80 Typical High $4,466.84 | Professional | 52 · Reduced service | $1,737.80 | $1,737.80 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $691.83 Typical High $1,778.28 | Professional | 53 · Discontinued | $691.83 | $691.83 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $512.86 Typical High $1,348.96 | Professional | 55 · Aftercare only | $512.86 | $512.86 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $891.25 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $891.25 |
Where Indiana sits
The same service costs 2.3 times more in Arkansas than in Vermont. 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· 39th of 51
$4,266
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.