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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $141.25 | Professional | None | $93.33 | $93.33 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $204.17 | Facility | None | $151.36 | $190.55 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $190.55 | Professional | None | $107.15 | $107.15 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $15.85 | Professional | RR · Rental | $10.72 | $10.72 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $79.43 Typical High $109.65 | Professional | UE · Used equipment | $79.43 | $79.43 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $302.00 | Facility | None | $288.40 | $288.40 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $190.55 | Facility | None | $123.03 | $123.03 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $977.24 | Professional | None | $89.13 | $123.03 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $467.74 Median $912.01 Typical High $2,137.96 | Facility | None | $467.74 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $234.42 | Professional | None | $120.23 | $158.49 | $234.42 |
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 $58.88 Median $93.33 Typical High $141.25 | Professional | None | $58.88 | $93.33 | $141.25 |
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 $46.77 Median $46.77 Typical High $70.79 | Professional | 52 · Reduced service | $46.77 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $28.18 | Professional | 53 · Discontinued | $18.62 | $18.62 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $20.89 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $14.13 |
Where Indiana sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 36th of 51
$107
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.