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 $61.66 Median $61.66 Typical High $109.65 | Facility | None | $61.66 | $61.66 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $102.33 | Professional | None | $61.66 | $61.66 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $125.89 Typical High $134.90 | Facility | None | $100.00 | $125.89 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $125.89 | Professional | None | $67.61 | $69.18 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.76 Typical High $9.55 | Professional | RR · Rental | $6.76 | $6.76 | $9.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | UE · Used equipment | $51.29 | $51.29 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $218.78 | Facility | None | $213.80 | $213.80 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $97.72 Typical High $125.89 | Facility | None | $89.13 | $97.72 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $616.60 | Professional | None | $64.57 | $89.13 | $616.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $186.21 Median $389.05 Typical High $2,187.76 | Facility | None | $186.21 | $389.05 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $177.83 | Professional | None | $79.43 | $104.71 | $177.83 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $75.86 | Facility | None | $72.44 | $72.44 | $75.86 |
United Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $91.20 | Professional | None | $37.15 | $61.66 | $91.20 |
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 $30.90 Median $30.90 Typical High $51.29 | Professional | 52 · Reduced service | $30.90 | $30.90 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $20.42 | Professional | 53 · Discontinued | $12.30 | $12.30 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $15.49 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $10.23 |
Where Indiana sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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
$69.18
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.