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 $35.48 Median $37.15 Typical High $42.66 | Professional | None | $35.48 | $37.15 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | None | $58.88 | $75.86 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $79.43 | Facility | None | $60.26 | $75.86 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $75.86 | Professional | None | $36.31 | $37.15 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $3.63 Typical High $5.50 | Professional | RR · Rental | $3.63 | $3.63 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $38.90 | Professional | UE · Used equipment | $27.54 | $27.54 | $38.90 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $91.20 | Facility | None | $87.10 | $87.10 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $75.86 | Facility | None | $48.98 | $48.98 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $346.74 | Professional | None | $35.48 | $48.98 | $346.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $186.21 Median $912.01 Typical High $2,137.96 | Facility | None | $186.21 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $93.33 | Professional | None | $47.86 | $61.66 | $93.33 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | None | $40.74 | $40.74 | $52.48 |
United Setting Professional Modifier None Typical Low $19.95 Median $36.31 Typical High $54.95 | Professional | None | $19.95 | $36.31 | $54.95 |
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 $17.78 Median $18.20 Typical High $21.38 | Professional | 52 · Reduced service | $17.78 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.41 Typical High $8.51 | Professional | 53 · Discontinued | $7.08 | $7.41 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.50 Typical High $6.31 | Professional | 55 · Aftercare only | $5.25 | $5.50 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.72 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.55 | $3.72 | $4.27 |
Where Indiana sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 30th of 51
$37.15
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.