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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $645.65 | Professional | None | $407.38 | $407.38 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $870.96 Typical High $912.01 | Facility | None | $691.83 | $870.96 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $870.96 | Professional | None | $389.05 | $389.05 | $870.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $54.95 | Professional | RR · Rental | $38.90 | $38.90 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | UE · Used equipment | $295.12 | $295.12 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $977.24 | Facility | None | $933.25 | $933.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $870.96 | Facility | None | $398.11 | $398.11 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $3,801.89 | Professional | None | $295.12 | $398.11 | $3,801.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,630.27 | Facility | None | $912.01 | $1,258.93 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,047.13 | Professional | None | $537.03 | $707.95 | $1,047.13 |
United Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $213.80 Median $426.58 Typical High $707.95 | Professional | None | $213.80 | $426.58 | $707.95 |
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 $204.17 Median $204.17 Typical High $323.59 | Professional | 52 · Reduced service | $204.17 | $204.17 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $128.82 | Professional | 53 · Discontinued | $81.28 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $97.72 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $64.57 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $64.57 |
Where Indiana sits
The same service costs 2.8 times more in Wisconsin 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· 36th of 51
$407
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.