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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | None | $102.33 | $102.33 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $213.80 Typical High $223.87 | Facility | None | $169.82 | $213.80 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $213.80 | Professional | None | $114.82 | $114.82 | $213.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $16.22 | Professional | RR · Rental | $11.48 | $11.48 | $16.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $125.89 | Professional | UE · Used equipment | $85.11 | $85.11 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Facility | None | $302.00 | $302.00 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $213.80 | Facility | None | $147.91 | $147.91 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $1,023.29 | Professional | None | $107.15 | $147.91 | $1,023.29 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $524.81 Median $912.01 Typical High $2,137.96 | Facility | None | $524.81 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $257.04 | Professional | None | $131.83 | $173.78 | $257.04 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $154.88 | Professional | None | $63.10 | $104.71 | $154.88 |
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 $51.29 Median $51.29 Typical High $74.13 | Professional | 52 · Reduced service | $51.29 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $29.51 | Professional | 53 · Discontinued | $20.89 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $21.88 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $14.79 |
Where Indiana sits
The same service costs 5.4 times more in Kansas than in West Virginia. 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· 36th of 51
$115
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.