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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $128.82 | Professional | None | $69.18 | $69.18 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $141.25 Typical High $151.36 | Facility | None | $112.20 | $141.25 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $141.25 | Professional | None | $81.28 | $81.28 | $141.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $12.30 | Professional | RR · Rental | $8.13 | $8.13 | $12.30 |
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 $269.15 Median $269.15 Typical High $281.84 | Facility | None | $269.15 | $269.15 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $141.25 | Facility | None | $91.20 | $91.20 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $741.31 | Professional | None | $66.07 | $91.20 | $741.31 |
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 $89.13 Median $117.49 Typical High $173.78 | Professional | None | $89.13 | $117.49 | $173.78 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $109.65 | Professional | None | $46.77 | $69.18 | $109.65 |
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 $34.67 Median $34.67 Typical High $64.57 | Professional | 52 · Reduced service | $34.67 | $34.67 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $26.30 | Professional | 53 · Discontinued | $13.80 | $13.80 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $19.50 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $12.88 |
Where Indiana sits
The same service costs 2.5 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· 36th 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.