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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $107.15 | Professional | None | $67.61 | $67.61 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $138.04 Typical High $147.91 | Facility | None | $109.65 | $138.04 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $138.04 | Professional | None | $81.28 | $85.11 | $138.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | RR · Rental | $8.13 | $8.13 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $61.66 Typical High $87.10 | Professional | UE · Used equipment | $61.66 | $61.66 | $87.10 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Facility | None | $223.87 | $223.87 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $95.50 Typical High $138.04 | Facility | None | $87.10 | $95.50 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $758.58 | Professional | None | $63.10 | $87.10 | $758.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $208.93 Median $436.52 Typical High $2,187.76 | Facility | None | $208.93 | $436.52 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $194.98 | Professional | None | $87.10 | $114.82 | $194.98 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $120.23 | Facility | None | $91.20 | $91.20 | $120.23 |
United Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $107.15 | Professional | None | $44.67 | $67.61 | $107.15 |
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 $33.88 Median $33.88 Typical High $53.70 | Professional | 52 · Reduced service | $33.88 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $21.88 | Professional | 53 · Discontinued | $13.49 | $13.49 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $16.22 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $10.96 |
Where Indiana sits
The same service costs 5.0 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· 35th of 51
$81.28
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.