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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $100.00 | Professional | None | $89.13 | $93.33 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $204.17 | Facility | None | $151.36 | $190.55 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $190.55 | Professional | None | $83.18 | $83.18 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.32 Median $8.32 Typical High $12.59 | Professional | RR · Rental | $8.32 | $8.32 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $87.10 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $213.80 | Facility | None | $208.93 | $208.93 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $190.55 | Facility | None | $89.13 | $89.13 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $794.33 | Professional | None | $64.57 | $89.13 | $794.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $467.74 Median $912.01 Typical High $2,137.96 | Facility | None | $467.74 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $234.42 | Professional | None | $120.23 | $158.49 | $234.42 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $87.10 | Facility | None | $70.79 | $70.79 | $87.10 |
United Setting Professional Modifier None Typical Low $46.77 Median $91.20 Typical High $138.04 | Professional | None | $46.77 | $91.20 | $138.04 |
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 $44.67 Median $46.77 Typical High $50.12 | Professional | 52 · Reduced service | $44.67 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.62 Typical High $19.95 | Professional | 53 · Discontinued | $17.78 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $15.14 | Professional | 55 · Aftercare only | $13.49 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $10.00 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii than in Florida. 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
$89.13
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.