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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $128.82 | Professional | None | $85.11 | $85.11 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $251.19 | Professional | None | $131.83 | $169.82 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $186.21 | Facility | None | $138.04 | $173.78 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $173.78 | Professional | None | $89.13 | $91.20 | $173.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $12.59 | Professional | RR · Rental | $8.91 | $8.91 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $66.07 Median $66.07 Typical High $93.33 | Professional | UE · Used equipment | $66.07 | $66.07 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $213.80 Typical High $218.78 | Facility | None | $144.54 | $213.80 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $204.17 | Professional | None | $144.54 | $190.55 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $173.78 | Facility | None | $97.72 | $97.72 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $812.83 | Professional | None | $70.79 | $97.72 | $812.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $549.54 Typical High $2,187.76 | Facility | None | $263.03 | $549.54 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $245.47 | Professional | None | $109.65 | $144.54 | $245.47 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $89.13 | Facility | None | $79.43 | $79.43 | $89.13 |
United Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $125.89 | Professional | None | $48.98 | $85.11 | $125.89 |
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 $42.66 Median $42.66 Typical High $51.29 | Professional | 52 · Reduced service | $42.66 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $20.42 | Professional | 53 · Discontinued | $16.98 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $10.23 |
Where Indiana sits
The same service costs 2.8 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· 35th of 51
$91.20
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.