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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | None | $74.13 | $74.13 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $151.36 Typical High $158.49 | Facility | None | $120.23 | $151.36 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $151.36 | Professional | None | $75.86 | $75.86 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.59 Median $7.59 Typical High $10.96 | Professional | RR · Rental | $7.59 | $7.59 | $10.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $57.54 Typical High $79.43 | Professional | UE · Used equipment | $57.54 | $57.54 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $190.55 | Facility | None | $186.21 | $186.21 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $151.36 | Facility | None | $104.71 | $104.71 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $707.95 | Professional | None | $75.86 | $104.71 | $707.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $371.54 Median $912.01 Typical High $2,137.96 | Facility | None | $371.54 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $186.21 | Professional | None | $95.50 | $125.89 | $186.21 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $85.11 | Facility | None | $75.86 | $75.86 | $85.11 |
United Setting Professional Modifier None Typical Low $42.66 Median $74.13 Typical High $109.65 | Professional | None | $42.66 | $74.13 | $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 $36.31 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $36.31 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $14.79 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $13.49 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $8.91 |
Where Indiana sits
The same service costs 3.0 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· 47th of 51
$75.86
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.