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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $50.12 Typical High $64.57 | Professional | None | $47.86 | $50.12 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $109.65 | Facility | None | $81.28 | $102.33 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $102.33 | Professional | None | $45.71 | $45.71 | $102.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $6.92 | Professional | RR · Rental | $4.57 | $4.57 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $47.86 | Professional | UE · Used equipment | $34.67 | $34.67 | $47.86 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $138.04 | Facility | None | $134.90 | $134.90 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $102.33 | Facility | None | $64.57 | $64.57 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $416.87 | Professional | None | $47.86 | $64.57 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $251.19 Median $912.01 Typical High $2,137.96 | Facility | None | $251.19 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $125.89 | Professional | None | $64.57 | $85.11 | $125.89 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $42.66 | Facility | None | $40.74 | $40.74 | $42.66 |
United Setting Professional Modifier None Typical Low $25.12 Median $50.12 Typical High $74.13 | Professional | None | $25.12 | $50.12 | $74.13 |
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 $23.99 Median $25.12 Typical High $32.36 | Professional | 52 · Reduced service | $23.99 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.00 Typical High $12.88 | Professional | 53 · Discontinued | $9.55 | $10.00 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.41 Typical High $9.77 | Professional | 55 · Aftercare only | $7.24 | $7.41 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.01 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.79 | $5.01 | $6.46 |
Where Indiana sits
The same service costs 2.3 times more in Wisconsin than in Washington, DC. 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
$47.86
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.