How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $524.81 | Professional | None | $251.19 | $251.19 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $512.86 | Facility | None | $263.03 | $263.03 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $537.03 | Professional | None | $263.03 | $263.03 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $794.33 | Facility | None | $758.58 | $758.58 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $446.68 Typical High $537.03 | Facility | None | $416.87 | $446.68 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $2,398.83 | Professional | None | $354.81 | $354.81 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $645.65 | Professional | None | $331.13 | $436.52 | $645.65 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $436.52 | Professional | None | $158.49 | $263.03 | $436.52 |
5 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 $125.89 Median $125.89 Typical High $263.03 | Professional | 52 · Reduced service | $125.89 | $125.89 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $104.71 | Professional | 53 · Discontinued | $50.12 | $50.12 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $79.43 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $52.48 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $52.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $281.84 Typical High $331.13 | Professional | UE · Used equipment | $199.53 | $281.84 | $331.13 |
Where Indiana sits
The same service costs 2.5 times more in Montana than in New York. 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· 50th of 51
$263
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.