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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $346.74 | Professional | None | $251.19 | $275.42 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $295.12 Median $371.54 Typical High $398.11 | Facility | None | $295.12 | $371.54 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $338.84 | Professional | None | $275.42 | $302.00 | $338.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | RR · Rental | $30.20 | $30.20 | $30.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | UE · Used equipment | $223.87 | $223.87 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $588.84 | Facility | None | $575.44 | $575.44 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $562.34 Median $1,096.48 Typical High $2,187.76 | Facility | None | $562.34 | $1,096.48 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $416.87 | Professional | None | $239.88 | $363.08 | $416.87 |
United Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $234.42 | Professional | None | $120.23 | $173.78 | $234.42 |
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 $125.89 Median $138.04 Typical High $173.78 | Professional | 52 · Reduced service | $125.89 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $56.23 Typical High $69.18 | Professional | 53 · Discontinued | $51.29 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $51.29 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $34.67 |
Where Indiana sits
The same service costs 4.4 times more in Hawaii 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· 27th of 51
$275
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.