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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $467.74 | Professional | None | $346.74 | $436.52 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $588.84 Typical High $630.96 | Facility | None | $467.74 | $588.84 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | None | $363.08 | $363.08 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | RR · Rental | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | UE · Used equipment | $275.42 | $275.42 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Facility | None | $691.83 | $691.83 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $346.74 | Facility | None | $181.97 | $181.97 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $2,187.76 | Facility | None | $891.25 | $1,737.80 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $660.69 | Professional | None | $380.19 | $562.34 | $660.69 |
United Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $354.81 | Professional | None | $147.91 | $269.15 | $354.81 |
4 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 $173.78 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $173.78 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $89.13 Typical High $93.33 | Professional | 53 · Discontinued | $69.18 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $34.67 | $43.65 | $46.77 |
Where Indiana sits
The same service costs 2.8 times more in Montana than in Florida. 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· 23rd of 51
$363
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.