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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $77.62 | Professional | None | $48.98 | $48.98 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $107.15 | Facility | None | $81.28 | $102.33 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $102.33 | Professional | None | $52.48 | $53.70 | $102.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $7.41 | Professional | RR · Rental | $5.25 | $5.25 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $58.88 | Professional | UE · Used equipment | $39.81 | $39.81 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $165.96 | Facility | None | $162.18 | $162.18 | $165.96 |
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 $46.77 Median $64.57 Typical High $489.78 | Professional | None | $46.77 | $64.57 | $489.78 |
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 $63.10 Median $83.18 Typical High $125.89 | Professional | None | $63.10 | $83.18 | $125.89 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
United Setting Professional Modifier None Typical Low $28.84 Median $50.12 Typical High $74.13 | Professional | None | $28.84 | $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 $24.55 Median $24.55 Typical High $38.90 | Professional | 52 · Reduced service | $24.55 | $24.55 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $15.49 | Professional | 53 · Discontinued | $10.00 | $10.00 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $11.75 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $7.76 |
Where Indiana sits
The same service costs 3.5 times more in Hawaii than in New Jersey. 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
$53.70
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.