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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | None | $77.62 | $77.62 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | None | $120.23 | $120.23 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $169.82 | Facility | None | $125.89 | $158.49 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $158.49 | Professional | None | $85.11 | $87.10 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $12.02 | Professional | RR · Rental | $8.51 | $8.51 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $87.10 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $213.80 Typical High $218.78 | Facility | None | $147.91 | $213.80 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $204.17 | Professional | None | $147.91 | $190.55 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $158.49 | Facility | None | $102.33 | $102.33 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $776.25 | Professional | None | $74.13 | $102.33 | $776.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $239.88 Median $512.86 Typical High $2,187.76 | Facility | None | $239.88 | $512.86 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $229.09 | Professional | None | $102.33 | $134.90 | $229.09 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $114.82 | Professional | None | $46.77 | $77.62 | $114.82 |
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 $38.90 Median $38.90 Typical High $51.29 | Professional | 52 · Reduced service | $38.90 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $20.42 | Professional | 53 · Discontinued | $15.49 | $15.49 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $15.49 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $10.23 |
Where Indiana sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 31st of 51
$87.10
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.