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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $138.04 | Professional | None | $120.23 | $125.89 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $257.04 Typical High $275.42 | Facility | None | $204.17 | $257.04 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $257.04 | Professional | None | $117.49 | $117.49 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $11.75 Typical High $16.60 | Professional | RR · Rental | $11.75 | $11.75 | $16.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | UE · Used equipment | $87.10 | $87.10 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Facility | None | $281.84 | $281.84 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $257.04 | Facility | None | $120.23 | $120.23 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $1,023.29 | Professional | None | $87.10 | $120.23 | $1,023.29 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $2,137.96 | Facility | None | $630.96 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $316.23 | Professional | None | $162.18 | $213.80 | $316.23 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $104.71 | Facility | None | $95.50 | $95.50 | $104.71 |
United Setting Professional Modifier None Typical Low $63.10 Median $123.03 Typical High $186.21 | Professional | None | $63.10 | $123.03 | $186.21 |
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 $60.26 Median $63.10 Typical High $67.61 | Professional | 52 · Reduced service | $60.26 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $27.54 | Professional | 53 · Discontinued | $23.99 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $20.42 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $13.80 |
Where Indiana sits
The same service costs 2.8 times more in Wisconsin 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· 24th of 51
$123
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.