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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $87.10 | Professional | None | $61.66 | $64.57 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $141.25 | Facility | None | $104.71 | $131.83 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $131.83 | Professional | None | $60.26 | $60.26 | $131.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $8.91 | Professional | RR · Rental | $6.03 | $6.03 | $8.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | UE · Used equipment | $44.67 | $44.67 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $190.55 | Facility | None | $181.97 | $181.97 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $131.83 | Facility | None | $83.18 | $83.18 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $549.54 | Professional | None | $61.66 | $83.18 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $912.01 Typical High $2,137.96 | Facility | None | $323.59 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $162.18 | Professional | None | $83.18 | $109.65 | $162.18 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Facility | None | $64.57 | $64.57 | $72.44 |
United Setting Professional Modifier None Typical Low $32.36 Median $64.57 Typical High $95.50 | Professional | None | $32.36 | $64.57 | $95.50 |
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 $30.90 Median $32.36 Typical High $43.65 | Professional | 52 · Reduced service | $30.90 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.88 Typical High $17.78 | Professional | 53 · Discontinued | $12.59 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.55 Typical High $13.18 | Professional | 55 · Aftercare only | $9.33 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.46 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.17 | $6.46 | $8.71 |
Where Indiana sits
The same service costs 3.5 times more in Hawaii 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· 25th of 51
$64.57
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.