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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $91.20 | Professional | None | $57.54 | $57.54 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $120.23 Typical High $125.89 | Facility | None | $95.50 | $120.23 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $120.23 | Professional | None | $70.79 | $70.79 | $120.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $10.47 | Professional | RR · Rental | $7.08 | $7.08 | $10.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $75.86 | Professional | UE · Used equipment | $52.48 | $52.48 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Facility | None | $190.55 | $190.55 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $120.23 | Facility | None | $75.86 | $75.86 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $645.65 | Professional | None | $54.95 | $75.86 | $645.65 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $912.01 Typical High $2,137.96 | Facility | None | $295.12 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $147.91 | Professional | None | $74.13 | $97.72 | $147.91 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $87.10 | Facility | None | $77.62 | $77.62 | $87.10 |
United Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $91.20 | Professional | None | $38.90 | $58.88 | $91.20 |
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 $28.84 Median $28.84 Typical High $45.71 | Professional | 52 · Reduced service | $28.84 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $18.62 | Professional | 53 · Discontinued | $11.48 | $11.48 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $13.80 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $9.12 |
Where Indiana sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 33rd of 51
$70.79
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.