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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $169.82 | Professional | None | $91.20 | $91.20 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $199.53 | Facility | None | $147.91 | $186.21 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $186.21 | Professional | None | $112.20 | $112.20 | $186.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $15.85 | Professional | RR · Rental | $11.22 | $11.22 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $83.18 Typical High $114.82 | Professional | UE · Used equipment | $83.18 | $83.18 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $371.54 | Facility | None | $354.81 | $354.81 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $186.21 | Facility | None | $125.89 | $125.89 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $1,071.52 | Professional | None | $91.20 | $125.89 | $1,071.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $2,137.96 | Facility | None | $457.09 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $229.09 | Professional | None | $117.49 | $154.88 | $229.09 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $144.54 | Professional | None | $61.66 | $91.20 | $144.54 |
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 $45.71 Median $45.71 Typical High $85.11 | Professional | 52 · Reduced service | $45.71 | $45.71 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $34.67 | Professional | 53 · Discontinued | $18.20 | $18.20 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $25.70 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $16.98 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $16.98 |
Where Indiana sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 38th of 51
$112
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.