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 $64.57 Median $64.57 Typical High $112.20 | Facility | None | $64.57 | $64.57 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $97.72 | Professional | None | $64.57 | $64.57 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $141.25 | Facility | None | $104.71 | $131.83 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $131.83 | Professional | None | $74.13 | $75.86 | $131.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $7.41 Typical High $10.47 | Professional | RR · Rental | $7.41 | $7.41 | $10.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | UE · Used equipment | $54.95 | $54.95 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $213.80 | Facility | None | $204.17 | $204.17 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $131.83 | Facility | None | $77.62 | $77.62 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $676.08 | Professional | None | $56.23 | $77.62 | $676.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $912.01 Typical High $2,137.96 | Facility | None | $323.59 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $162.18 | Professional | None | $81.28 | $107.15 | $162.18 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $81.28 | Facility | None | $60.26 | $60.26 | $81.28 |
United Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $97.72 | Professional | None | $40.74 | $64.57 | $97.72 |
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 $31.62 Median $31.62 Typical High $48.98 | Professional | 52 · Reduced service | $31.62 | $31.62 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $19.95 | Professional | 53 · Discontinued | $12.88 | $12.88 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $14.79 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $9.77 |
Where Indiana sits
The same service costs 3.1 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· 34th of 51
$74.13
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.