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 $117.49 Median $141.25 Typical High $208.93 | Facility | None | $117.49 | $141.25 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $275.42 | Professional | None | $117.49 | $117.49 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $41.69 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $27.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $239.88 | Facility | None | $123.03 | $123.03 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $251.19 | Professional | None | $123.03 | $123.03 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $416.87 | Facility | None | $398.11 | $398.11 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $208.93 Typical High $251.19 | Facility | None | $194.98 | $208.93 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $1,202.26 | Professional | None | $165.96 | $165.96 | $1,202.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $2,187.76 | Facility | None | $758.58 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $309.03 | Professional | None | $158.49 | $204.17 | $309.03 |
United Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $204.17 | Professional | None | $79.43 | $123.03 | $204.17 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $141.25 Typical High $173.78 | Professional | UE · Used equipment | $93.33 | $141.25 | $173.78 |
Where Indiana sits
The same service costs 2.6 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
$129
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.