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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $74.13 | Professional | None | $52.48 | $52.48 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $107.15 Typical High $114.82 | Facility | None | $85.11 | $107.15 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $107.15 | Professional | None | $56.23 | $56.23 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $8.51 | Professional | RR · Rental | $5.62 | $5.62 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | UE · Used equipment | $42.66 | $42.66 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $158.49 | Facility | None | $154.88 | $154.88 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $107.15 | Facility | None | $67.61 | $67.61 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $512.86 | Professional | None | $50.12 | $67.61 | $512.86 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $162.18 Median $338.84 Typical High $2,187.76 | Facility | None | $162.18 | $338.84 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $151.36 | Professional | None | $67.61 | $89.13 | $151.36 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $60.26 | Facility | None | $32.36 | $32.36 | $60.26 |
United Setting Professional Modifier None Typical Low $30.90 Median $52.48 Typical High $77.62 | Professional | None | $30.90 | $52.48 | $77.62 |
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 $25.70 Median $25.70 Typical High $37.15 | Professional | 52 · Reduced service | $25.70 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $14.79 | Professional | 53 · Discontinued | $10.47 | $10.47 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $10.96 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $7.41 |
Where Indiana sits
The same service costs 2.1 times more in Montana 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· 32nd of 51
$56.23
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.