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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | None | $52.48 | $52.48 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $107.15 Typical High $114.82 | Facility | None | $85.11 | $107.15 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $107.15 | Professional | None | $58.88 | $58.88 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.89 Median $5.89 Typical High $8.32 | Professional | RR · Rental | $5.89 | $5.89 | $8.32 |
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 $144.54 Median $144.54 Typical High $147.91 | Facility | None | $144.54 | $144.54 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $107.15 | Facility | None | $72.44 | $72.44 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $72.44 Typical High $537.03 | Professional | None | $53.70 | $72.44 | $537.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $912.01 Typical High $2,137.96 | Facility | None | $263.03 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $131.83 | Professional | None | $67.61 | $89.13 | $131.83 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $64.57 | Facility | None | $47.86 | $47.86 | $64.57 |
United Setting Professional Modifier None Typical Low $32.36 Median $52.48 Typical High $79.43 | Professional | None | $32.36 | $52.48 | $79.43 |
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 $26.30 Median $26.30 Typical High $34.67 | Professional | 52 · Reduced service | $26.30 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $13.80 | Professional | 53 · Discontinued | $10.47 | $10.47 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $10.47 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $6.92 |
Where Indiana sits
The same service costs 3.2 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· 39th of 51
$58.88
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.