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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | None | $37.15 | $37.15 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | None | $57.54 | $57.54 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $81.28 | Facility | None | $61.66 | $77.62 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $46.77 Typical High $77.62 | Professional | None | $45.71 | $46.77 | $77.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $6.92 | Professional | RR · Rental | $4.57 | $4.57 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $48.98 | Professional | UE · Used equipment | $33.88 | $33.88 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Facility | None | $125.89 | $125.89 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $77.62 | Facility | None | $48.98 | $48.98 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $416.87 | Professional | None | $35.48 | $48.98 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $190.55 Median $912.01 Typical High $2,137.96 | Facility | None | $190.55 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $95.50 | Professional | None | $47.86 | $63.10 | $95.50 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Facility | None | $50.12 | $50.12 | $64.57 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $60.26 | Professional | None | $25.12 | $38.02 | $60.26 |
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 $18.62 Median $18.62 Typical High $30.20 | Professional | 52 · Reduced service | $18.62 | $18.62 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $12.30 | Professional | 53 · Discontinued | $7.59 | $7.59 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $9.12 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $6.03 |
Where Indiana sits
The same service costs 4.7 times more in Hawaii 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· 34th of 51
$45.71
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.