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 $66.07 Median $67.61 Typical High $74.13 | Professional | None | $66.07 | $67.61 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $141.25 Typical High $147.91 | Facility | None | $112.20 | $141.25 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $141.25 | Professional | None | $60.26 | $60.26 | $141.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.61 Typical High $60.26 | Professional | RR · Rental | $6.03 | $6.61 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | UE · Used equipment | $45.71 | $45.71 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $154.88 | Facility | None | $151.36 | $151.36 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $141.25 | Facility | None | $64.57 | $64.57 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $588.84 | Professional | None | $46.77 | $64.57 | $588.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $346.74 Median $912.01 Typical High $2,137.96 | Facility | None | $346.74 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $173.78 | Professional | None | $87.10 | $114.82 | $173.78 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Facility | None | $50.12 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $34.67 Median $66.07 Typical High $102.33 | Professional | None | $34.67 | $66.07 | $102.33 |
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 $33.11 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $33.11 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $13.18 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.76 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.61 | $6.76 | $7.41 |
Where Indiana sits
The same service costs 2.8 times more in Wisconsin 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· 26th of 51
$66.07
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.