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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | None | $79.43 | $79.43 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $173.78 | Facility | None | $128.82 | $162.18 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $162.18 | Professional | None | $79.43 | $79.43 | $162.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.94 Median $7.94 Typical High $11.75 | Professional | RR · Rental | $7.94 | $7.94 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | UE · Used equipment | $58.88 | $58.88 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Facility | None | $190.55 | $190.55 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $162.18 | Facility | None | $102.33 | $102.33 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $741.31 | Professional | None | $75.86 | $102.33 | $741.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $398.11 Median $912.01 Typical High $2,137.96 | Facility | None | $398.11 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $199.53 | Professional | None | $102.33 | $134.90 | $199.53 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $87.10 | Facility | None | $75.86 | $75.86 | $87.10 |
United Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $117.49 | Professional | None | $43.65 | $79.43 | $117.49 |
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 $39.81 Median $39.81 Typical High $45.71 | Professional | 52 · Reduced service | $39.81 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $18.62 | Professional | 53 · Discontinued | $15.85 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $9.33 |
Where Indiana sits
The same service costs 3.2 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
$79.43
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.