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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $660.69 | Professional | None | $316.23 | $316.23 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $645.65 | Facility | None | $331.13 | $331.13 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $676.08 | Professional | None | $331.13 | $331.13 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Facility | None | $977.24 | $977.24 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $398.11 Typical High $676.08 | Facility | None | $371.54 | $398.11 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $3,019.95 | Professional | None | $316.23 | $389.05 | $3,019.95 |
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 $416.87 Median $549.54 Typical High $831.76 | Professional | None | $416.87 | $549.54 | $831.76 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $549.54 | Professional | None | $199.53 | $331.13 | $549.54 |
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 $158.49 Median $158.49 Typical High $331.13 | Professional | 52 · Reduced service | $158.49 | $158.49 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $134.90 | Professional | 53 · Discontinued | $63.10 | $63.10 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $100.00 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $66.07 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $251.19 Median $354.81 Typical High $416.87 | Professional | UE · Used equipment | $251.19 | $354.81 | $416.87 |
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· 42nd of 51
$331
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.