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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $275.42 | Professional | None | $234.42 | $245.47 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $537.03 | Facility | None | $398.11 | $501.19 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $501.19 | Professional | None | $239.88 | $239.88 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $35.48 | Professional | RR · Rental | $23.99 | $23.99 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $257.04 | Professional | UE · Used equipment | $181.97 | $181.97 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $588.84 | Facility | None | $575.44 | $575.44 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $501.19 | Facility | None | $245.47 | $245.47 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $2,187.76 | Professional | None | $177.83 | $245.47 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $616.60 | Professional | None | $309.03 | $407.38 | $616.60 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Facility | None | $147.91 | $147.91 | $204.17 |
United Setting Professional Modifier None Typical Low $131.83 Median $245.47 Typical High $363.08 | Professional | None | $131.83 | $245.47 | $363.08 |
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 $117.49 Median $123.03 Typical High $138.04 | Professional | 52 · Reduced service | $117.49 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $46.77 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $35.48 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $27.54 |
Where Indiana sits
The same service costs 2.9 times more in Montana 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· 32nd of 51
$245
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.