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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $407.38 | Professional | None | $257.04 | $257.04 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $524.81 | Facility | None | $269.15 | $269.15 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $549.54 | Professional | None | $269.15 | $269.15 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $602.56 | Facility | None | $588.84 | $588.84 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $269.15 Typical High $549.54 | Facility | None | $251.19 | $269.15 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $2,041.74 | Professional | None | $199.53 | $269.15 | $2,041.74 |
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 $338.84 Median $446.68 Typical High $660.69 | Professional | None | $338.84 | $446.68 | $660.69 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $446.68 | Professional | None | $134.90 | $269.15 | $446.68 |
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 $128.82 Median $128.82 Typical High $204.17 | Professional | 52 · Reduced service | $128.82 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $81.28 | Professional | 53 · Discontinued | $51.29 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $60.26 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $40.74 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $40.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $245.47 Typical High $251.19 | Professional | UE · Used equipment | $181.97 | $245.47 | $251.19 |
Where Indiana sits
The same service costs 3.4 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· 21st of 51
$269
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.