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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $45.71 Typical High $79.43 | Professional | None | $44.67 | $45.71 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $100.00 | Professional | None | $67.61 | $69.18 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $97.72 | Facility | None | $72.44 | $91.20 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $91.20 | Professional | None | $54.95 | $54.95 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $8.13 | Professional | RR · Rental | $5.50 | $5.50 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | UE · Used equipment | $40.74 | $40.74 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $134.90 Typical High $138.04 | Facility | None | $93.33 | $134.90 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $128.82 | Professional | None | $93.33 | $120.23 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $64.57 Typical High $91.20 | Facility | None | $57.54 | $64.57 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $501.19 | Professional | None | $42.66 | $57.54 | $501.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $134.90 Median $281.84 Typical High $2,187.76 | Facility | None | $134.90 | $281.84 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $131.83 | Professional | None | $58.88 | $75.86 | $131.83 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Facility | None | $43.65 | $43.65 | $51.29 |
United Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $70.79 | Professional | None | $30.20 | $44.67 | $70.79 |
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 $22.39 Median $22.39 Typical High $32.36 | Professional | 52 · Reduced service | $22.39 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $12.88 | Professional | 53 · Discontinued | $8.91 | $8.91 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $9.77 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $6.46 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii 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· 34th of 51
$54.95
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.