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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $436.52 | Professional | None | $199.53 | $199.53 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $407.38 | Facility | None | $208.93 | $208.93 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $426.58 | Professional | None | $208.93 | $208.93 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Facility | None | $630.96 | $630.96 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $426.58 | Facility | None | $257.04 | $371.54 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $2,137.96 | Professional | None | $316.23 | $346.74 | $2,137.96 |
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 $263.03 Median $346.74 Typical High $512.86 | Professional | None | $263.03 | $346.74 | $512.86 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $346.74 | Professional | None | $141.25 | $208.93 | $346.74 |
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 $100.00 Median $100.00 Typical High $218.78 | Professional | 52 · Reduced service | $100.00 | $100.00 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $87.10 | Professional | 53 · Discontinued | $39.81 | $39.81 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $66.07 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $43.65 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $43.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $251.19 Typical High $331.13 | Professional | UE · Used equipment | $158.49 | $251.19 | $331.13 |
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· 50th of 51
$209
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.