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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $47.86 | Professional | None | $38.90 | $40.74 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $89.13 | Facility | None | $66.07 | $83.18 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $83.18 | Professional | None | $40.74 | $41.69 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $5.75 | Professional | RR · Rental | $4.07 | $4.07 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $42.66 | Professional | UE · Used equipment | $30.20 | $30.20 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $102.33 | Facility | None | $100.00 | $100.00 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $83.18 | Facility | None | $36.31 | $36.31 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $371.54 | Professional | None | $26.92 | $36.31 | $371.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $2,137.96 | Facility | None | $204.17 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $102.33 | Professional | None | $52.48 | $69.18 | $102.33 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $22.39 Median $40.74 Typical High $60.26 | Professional | None | $22.39 | $40.74 | $60.26 |
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 $19.50 Median $19.95 Typical High $23.99 | Professional | 52 · Reduced service | $19.50 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.13 Typical High $9.55 | Professional | 53 · Discontinued | $7.94 | $8.13 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.03 Typical High $7.24 | Professional | 55 · Aftercare only | $5.89 | $6.03 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.07 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.98 | $4.07 | $4.79 |
Where Indiana sits
The same service costs 2.9 times more in Hawaii than in Delaware. 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· 34th of 51
$40.74
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.