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 $22,387.21 Median $22,387.21 Typical High $22,387.21 | Facility | None | $22,387.21 | $22,387.21 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $38,904.51 | Professional | None | $22,387.21 | $22,387.21 | $38,904.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $38,018.94 Median $47,863.01 Typical High $51,286.14 | Facility | None | $38,018.94 | $47,863.01 | $51,286.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $23,988.33 Median $23,988.33 Typical High $47,863.01 | Professional | None | $23,988.33 | $23,988.33 | $47,863.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,398.83 Median $2,398.83 Typical High $3,388.44 | Professional | RR · Rental | $2,398.83 | $2,398.83 | $3,388.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17,782.79 Median $17,782.79 Typical High $25,703.96 | Professional | UE · Used equipment | $17,782.79 | $17,782.79 | $25,703.96 |
CareSource Setting Facility Modifier None Typical Low $56,234.13 Median $56,234.13 Typical High $58,884.37 | Facility | None | $56,234.13 | $56,234.13 | $58,884.37 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $47,863.01 | Facility | None | $30,199.52 | $30,199.52 | $47,863.01 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $30,199.52 Typical High $213,796.21 | Professional | None | $22,387.21 | $30,199.52 | $213,796.21 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $70,794.58 Typical High $147,910.84 | Facility | None | $912.01 | $70,794.58 | $147,910.84 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $30,199.52 Median $39,810.72 Typical High $67,608.30 | Professional | None | $30,199.52 | $39,810.72 | $67,608.30 |
United Setting Professional Modifier None Typical Low $13,182.57 Median $23,442.29 Typical High $38,904.51 | Professional | None | $13,182.57 | $23,442.29 | $38,904.51 |
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 $11,220.18 Median $11,220.18 Typical High $19,498.45 | Professional | 52 · Reduced service | $11,220.18 | $11,220.18 | $19,498.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4,466.84 Median $4,466.84 Typical High $7,762.47 | Professional | 53 · Discontinued | $4,466.84 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3,388.44 Median $3,388.44 Typical High $5,888.44 | Professional | 55 · Aftercare only | $3,388.44 | $3,388.44 | $5,888.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2,238.72 Median $2,238.72 Typical High $3,890.45 | Professional | 56 · Pre-op care only | $2,238.72 | $2,238.72 | $3,890.45 |
Where Indiana sits
The same service costs 2.1 times more in Hawaii 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· 34th of 51
$23,988
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.