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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | None | $77.62 | $77.62 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $169.82 | Facility | None | $125.89 | $158.49 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $158.49 | Professional | None | $83.18 | $83.18 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.32 Median $8.32 Typical High $12.02 | Professional | RR · Rental | $8.32 | $8.32 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | UE · Used equipment | $63.10 | $63.10 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $208.93 | Facility | None | $199.53 | $199.53 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $158.49 | Facility | None | $87.10 | $87.10 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $741.31 | Professional | None | $63.10 | $87.10 | $741.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $389.05 Median $912.01 Typical High $2,137.96 | Facility | None | $389.05 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $194.98 | Professional | None | $100.00 | $131.83 | $194.98 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $114.82 | Professional | None | $45.71 | $77.62 | $114.82 |
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 $38.90 Median $38.90 Typical High $47.86 | Professional | 52 · Reduced service | $38.90 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $15.49 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $14.45 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $9.55 |
Where Indiana sits
The same service costs 2.5 times more in Arkansas than in Florida. 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
$83.18
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.