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 $97.72 | Professional | None | $69.18 | $69.18 | $97.72 |
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 $85.11 Median $85.11 Typical High $141.25 | Professional | None | $85.11 | $85.11 | $141.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $12.30 | Professional | RR · Rental | $8.51 | $8.51 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | UE · Used equipment | $63.10 | $63.10 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $208.93 | Facility | None | $199.53 | $199.53 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $141.25 | Facility | None | $89.13 | $89.13 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $776.25 | Professional | None | $66.07 | $89.13 | $776.25 |
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 $93.33 Median $93.33 Typical High $114.82 | Facility | None | $93.33 | $93.33 | $114.82 |
United Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $109.65 | Professional | None | $45.71 | $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 $48.98 | Professional | 52 · Reduced service | $34.67 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $19.50 | Professional | 53 · Discontinued | $13.80 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $14.45 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $9.77 |
Where Indiana sits
The same service costs 5.1 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· 37th of 51
$85.11
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.