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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $56.23 | Professional | None | $30.90 | $30.90 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $64.57 Typical High $67.61 | Facility | None | $51.29 | $64.57 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $64.57 | Professional | None | $37.15 | $37.15 | $64.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.72 Median $3.72 Typical High $5.50 | Professional | RR · Rental | $3.72 | $3.72 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | UE · Used equipment | $27.54 | $27.54 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $120.23 | Facility | None | $114.82 | $114.82 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $64.57 | Facility | None | $40.74 | $40.74 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $346.74 | Professional | None | $29.51 | $40.74 | $346.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $158.49 Median $912.01 Typical High $2,137.96 | Facility | None | $158.49 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $79.43 | Professional | None | $39.81 | $52.48 | $79.43 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $40.74 | Facility | None | $36.31 | $36.31 | $40.74 |
United Setting Professional Modifier None Typical Low $20.89 Median $31.62 Typical High $48.98 | Professional | None | $20.89 | $31.62 | $48.98 |
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 $15.49 Median $15.49 Typical High $27.54 | Professional | 52 · Reduced service | $15.49 | $15.49 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $11.22 | Professional | 53 · Discontinued | $6.31 | $6.31 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $8.32 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $5.62 |
Where Indiana sits
The same service costs 2.7 times more in Montana 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· 44th of 51
$37.15
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.