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 $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $4.07 | Professional | None | $2.69 | $4.07 | $4.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $4.17 | Facility | None | $2.14 | $2.14 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $4.90 | Professional | None | $2.14 | $2.14 | $4.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.21 Median $0.21 Typical High $0.27 | Professional | RR · Rental | $0.21 | $0.21 | $0.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.62 Median $1.62 Typical High $2.14 | Professional | UE · Used equipment | $1.62 | $1.62 | $2.14 |
CareSource Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.08 | Facility | None | $6.92 | $6.92 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $23.44 | Professional | None | $2.00 | $2.00 | $23.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $14.79 Median $912.01 Typical High $2,187.76 | Facility | None | $14.79 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.88 Median $3.55 Typical High $7.08 | Professional | None | $2.88 | $3.55 | $7.08 |
United Setting Professional Modifier None Typical Low $1.35 Median $2.40 Typical High $3.98 | Professional | None | $1.35 | $2.40 | $3.98 |
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 $1.35 Median $2.04 Typical High $2.04 | Professional | 52 · Reduced service | $1.35 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.81 Typical High $0.81 | Professional | 53 · Discontinued | $0.52 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.62 Typical High $0.62 | Professional | 55 · Aftercare only | $0.40 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.41 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.27 | $0.41 | $0.41 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii than in Maine. 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
$2.14
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.