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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $56.23 | Professional | None | $36.31 | $56.23 | $56.23 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $81.28 | Facility | None | $41.69 | $41.69 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $67.61 | Professional | None | $41.69 | $41.69 | $67.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.17 Median $4.17 Typical High $5.89 | Professional | RR · Rental | $4.17 | $4.17 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $46.77 | Professional | UE · Used equipment | $31.62 | $31.62 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $97.72 | Facility | None | $95.50 | $95.50 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $42.66 | Facility | None | $39.81 | $39.81 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $323.59 | Professional | None | $33.88 | $39.81 | $323.59 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $2,187.76 | Facility | None | $204.17 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $95.50 | Professional | None | $40.74 | $53.70 | $95.50 |
United Setting Professional Modifier None Typical Low $18.62 Median $33.11 Typical High $54.95 | Professional | None | $18.62 | $33.11 | $54.95 |
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 $18.62 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $18.62 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $7.41 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $5.50 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.72 | $5.62 | $5.62 |
Where Indiana sits
The same service costs 2.3 times more in Kansas 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· 27th of 51
$41.69
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.