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 $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $3.80 Typical High $3.80 | Professional | None | $2.14 | $3.80 | $3.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $4.37 | Facility | None | $2.24 | $2.24 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $4.57 | Professional | None | $2.24 | $2.24 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $0.23 Typical High $0.32 | Professional | RR · Rental | $0.23 | $0.23 | $0.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.70 Median $1.70 Typical High $2.45 | Professional | UE · Used equipment | $1.70 | $1.70 | $2.45 |
CareSource Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.62 | Facility | None | $5.50 | $5.50 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $2.88 | Facility | None | $2.69 | $2.69 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.69 Typical High $19.95 | Professional | None | $2.29 | $2.69 | $19.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $13.80 Median $912.01 Typical High $2,187.76 | Facility | None | $13.80 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.69 Median $3.63 Typical High $5.62 | Professional | None | $2.69 | $3.63 | $5.62 |
United Setting Professional Modifier None Typical Low $1.26 Median $2.14 Typical High $3.72 | Professional | None | $1.26 | $2.14 | $3.72 |
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 $1.07 Median $1.91 Typical High $1.91 | Professional | 52 · Reduced service | $1.07 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.76 Typical High $0.76 | Professional | 53 · Discontinued | $0.42 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.32 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.38 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.21 | $0.38 | $0.38 |
Where Indiana sits
The same service costs 2.1 times more in Montana than in New Hampshire. 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· 48th of 51
$2.29
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.