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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,318.26 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,290.87 | Facility | None | $1,380.38 | $1,737.80 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,737.80 | $2,290.87 | $2,290.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | RR · Rental | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | UE · Used equipment | $1,737.80 | $1,737.80 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,570.40 | Facility | None | $2,511.89 | $2,511.89 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,570.40 Typical High $5,495.41 | Facility | None | $912.01 | $2,570.40 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,659.59 | $1,949.84 |
United Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,047.13 | Professional | None | $512.86 | $794.33 | $1,047.13 |
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 $602.56 Median $660.69 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $263.03 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $131.83 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $131.83 | $144.54 |
Where Indiana sits
The same service costs 2.7 times more in Montana than in New Jersey. 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· 22nd of 51
$1,318
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.