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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $37.15 | Professional | None | $30.20 | $30.20 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | None | $47.86 | $47.86 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $61.66 Typical High $66.07 | Facility | None | $48.98 | $61.66 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $61.66 | Professional | None | $32.36 | $33.11 | $61.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $4.79 | Professional | RR · Rental | $3.24 | $3.24 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | UE · Used equipment | $23.99 | $23.99 | $33.11 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $79.43 | Facility | None | $77.62 | $77.62 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $61.66 | Facility | None | $38.90 | $38.90 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $309.03 | Professional | None | $28.84 | $38.90 | $309.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $151.36 Median $912.01 Typical High $2,137.96 | Facility | None | $151.36 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $75.86 | Professional | None | $38.90 | $51.29 | $75.86 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $51.29 | Facility | None | $35.48 | $35.48 | $51.29 |
United Setting Professional Modifier None Typical Low $17.78 Median $30.20 Typical High $44.67 | Professional | None | $17.78 | $30.20 | $44.67 |
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 $15.14 Median $15.14 Typical High $18.62 | Professional | 52 · Reduced service | $15.14 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $7.59 | Professional | 53 · Discontinued | $6.03 | $6.03 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.72 |
Where Indiana sits
The same service costs 4.7 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
$32.36
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.