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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | None | $87.10 | $87.10 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $181.97 Typical High $190.55 | Facility | None | $141.25 | $181.97 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $181.97 | Professional | None | $91.20 | $93.33 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $9.12 Typical High $12.88 | Professional | RR · Rental | $9.12 | $9.12 | $12.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $95.50 | Professional | UE · Used equipment | $69.18 | $69.18 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $223.87 | Facility | None | $218.78 | $218.78 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $181.97 | Facility | None | $97.72 | $97.72 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $851.14 | Professional | None | $70.79 | $97.72 | $851.14 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $446.68 Median $912.01 Typical High $2,137.96 | Facility | None | $446.68 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $223.87 | Professional | None | $112.20 | $147.91 | $223.87 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Facility | None | $95.50 | $95.50 | $100.00 |
United Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $131.83 | Professional | None | $50.12 | $89.13 | $131.83 |
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 $43.65 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $43.65 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $17.38 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $10.47 |
Where Indiana sits
The same service costs 3.2 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· 40th of 51
$91.20
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.