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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $58.88 | Professional | None | $35.48 | $35.48 | $58.88 |
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 $57.54 Median $74.13 Typical High $77.62 | Facility | None | $57.54 | $74.13 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $74.13 | Professional | None | $42.66 | $43.65 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $6.03 | Professional | RR · Rental | $4.27 | $4.27 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $47.86 | Professional | UE · Used equipment | $31.62 | $31.62 | $47.86 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $125.89 | Facility | None | $123.03 | $123.03 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $74.13 | Facility | None | $46.77 | $46.77 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $407.38 | Professional | None | $33.88 | $46.77 | $407.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $181.97 Median $912.01 Typical High $2,137.96 | Facility | None | $181.97 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $91.20 | Professional | None | $45.71 | $60.26 | $91.20 |
United Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $36.31 | Facility | None | $19.05 | $19.05 | $36.31 |
United Setting Professional Modifier None Typical Low $23.99 Median $36.31 Typical High $57.54 | Professional | None | $23.99 | $36.31 | $57.54 |
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 $17.78 Median $17.78 Typical High $29.51 | Professional | 52 · Reduced service | $17.78 | $17.78 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $11.75 | Professional | 53 · Discontinued | $7.08 | $7.08 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $8.91 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $5.89 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $5.89 |
Where Indiana sits
The same service costs 2.9 times more in Kansas 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· 39th of 51
$42.66
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.