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 $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $13.80 | Professional | None | $10.23 | $10.23 | $13.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.60 Median $20.89 Typical High $22.39 | Facility | None | $16.60 | $20.89 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $20.89 | Professional | None | $11.48 | $11.48 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.15 Median $1.15 Typical High $1.78 | Professional | RR · Rental | $1.15 | $1.15 | $1.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.71 Median $8.71 Typical High $12.30 | Professional | UE · Used equipment | $8.71 | $8.71 | $12.30 |
CareSource Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Facility | None | $28.84 | $28.84 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $20.89 | Facility | None | $13.49 | $13.49 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $13.49 Typical High $107.15 | Professional | None | $9.77 | $13.49 | $107.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $51.29 Median $912.01 Typical High $2,137.96 | Facility | None | $51.29 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $13.18 Median $17.38 Typical High $25.70 | Professional | None | $13.18 | $17.38 | $25.70 |
United Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Facility | None | $7.94 | $7.94 | $9.77 |
United Setting Professional Modifier None Typical Low $6.61 Median $10.23 Typical High $15.49 | Professional | None | $6.61 | $10.23 | $15.49 |
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 $5.13 Median $5.13 Typical High $6.92 | Professional | 52 · Reduced service | $5.13 | $5.13 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.04 Typical High $2.75 | Professional | 53 · Discontinued | $2.04 | $2.04 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $2.04 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.02 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.02 | $1.02 | $1.38 |
Where Indiana sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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
$11.48
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.