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Indiana rates for HCPCS E1355

Stand/Rack (Special Coverage Instructions Apply. See Cim: 60-4)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.45 / $18.45 / $18.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.90 / $18.45 / $22.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.56 / $26.69 / $29.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $20.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.35 / $35.78 / $44.73
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.82 / $34.29 / $40.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.96 / $18.96 / $18.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.12 / $16.12 / $30.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.43 / $14.26 / $23.12