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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $66.07 | Professional | None | $46.77 | $46.77 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $102.33 | Facility | None | $75.86 | $95.50 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $58.88 Typical High $95.50 | Professional | None | $57.54 | $58.88 | $95.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $8.13 | Professional | RR · Rental | $5.75 | $5.75 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $64.57 | Professional | UE · Used equipment | $42.66 | $42.66 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Facility | None | $138.04 | $138.04 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $95.50 | Facility | None | $58.88 | $58.88 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $58.88 Typical High $501.19 | Professional | None | $42.66 | $58.88 | $501.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $234.42 Median $912.01 Typical High $2,137.96 | Facility | None | $234.42 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $117.49 | Professional | None | $60.26 | $79.43 | $117.49 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $46.77 | Facility | None | $40.74 | $40.74 | $46.77 |
United Setting Professional Modifier None Typical Low $31.62 Median $46.77 Typical High $74.13 | Professional | None | $31.62 | $46.77 | $74.13 |
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 $23.44 Median $23.44 Typical High $33.11 | Professional | 52 · Reduced service | $23.44 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $13.18 | Professional | 53 · Discontinued | $9.33 | $9.33 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $10.00 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $6.61 |
Where Indiana sits
The same service costs 2.5 times more in Arkansas 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· 36th of 51
$57.54
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.