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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | None | $63.10 | $63.10 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $138.04 | Facility | None | $104.71 | $131.83 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $131.83 | Professional | None | $77.62 | $77.62 | $131.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.76 Median $7.76 Typical High $11.75 | Professional | RR · Rental | $7.76 | $7.76 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | UE · Used equipment | $58.88 | $58.88 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $194.98 | Facility | None | $186.21 | $186.21 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $131.83 | Facility | None | $81.28 | $81.28 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $707.95 | Professional | None | $58.88 | $81.28 | $707.95 |
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 $79.43 Median $79.43 Typical High $85.11 | Facility | None | $79.43 | $79.43 | $85.11 |
United Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $102.33 | Professional | None | $42.66 | $64.57 | $102.33 |
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 $44.67 | Professional | 52 · Reduced service | $31.62 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $18.20 | Professional | 53 · Discontinued | $12.88 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $13.49 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $8.91 |
Where Indiana sits
The same service costs 5.1 times more in Kansas 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· 37th of 51
$77.62
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.