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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $186.21 | Professional | None | $104.71 | $104.71 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $213.80 Typical High $229.09 | Facility | None | $169.82 | $213.80 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $213.80 | Professional | None | $123.03 | $123.03 | $213.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $18.62 | Professional | RR · Rental | $12.30 | $12.30 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $91.20 Median $91.20 Typical High $128.82 | Professional | UE · Used equipment | $91.20 | $91.20 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Facility | None | $389.05 | $389.05 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $213.80 | Facility | None | $134.90 | $134.90 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $1,122.02 | Professional | None | $100.00 | $134.90 | $1,122.02 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $524.81 Median $912.01 Typical High $2,137.96 | Facility | None | $524.81 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $257.04 | Professional | None | $134.90 | $177.83 | $257.04 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $128.82 | Facility | None | $63.10 | $63.10 | $128.82 |
United Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $162.18 | Professional | None | $67.61 | $104.71 | $162.18 |
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 $52.48 Median $52.48 Typical High $93.33 | Professional | 52 · Reduced service | $52.48 | $52.48 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $38.02 | Professional | 53 · Discontinued | $20.89 | $20.89 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $28.18 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $18.62 |
Where Indiana sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 31st of 51
$123
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.