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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $75.86 | Professional | None | $46.77 | $46.77 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $102.33 | Facility | None | $77.62 | $97.72 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $97.72 | Professional | None | $48.98 | $51.29 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $6.92 | Professional | RR · Rental | $4.90 | $4.90 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | UE · Used equipment | $37.15 | $37.15 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $162.18 | Facility | None | $158.49 | $158.49 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $97.72 | Facility | None | $61.66 | $61.66 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $457.09 | Professional | None | $44.67 | $61.66 | $457.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $239.88 Median $912.01 Typical High $2,137.96 | Facility | None | $239.88 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $120.23 | Professional | None | $60.26 | $79.43 | $120.23 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $45.71 | Facility | None | $41.69 | $41.69 | $45.71 |
United Setting Professional Modifier None Typical Low $26.92 Median $47.86 Typical High $70.79 | Professional | None | $26.92 | $47.86 | $70.79 |
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 $23.44 Median $23.44 Typical High $38.02 | Professional | 52 · Reduced service | $23.44 | $23.44 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $15.14 | Professional | 53 · Discontinued | $9.33 | $9.33 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $11.48 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $7.59 |
Where Indiana sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$51.29
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.