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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $109.65 | Professional | None | $75.86 | $77.62 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $169.82 | Facility | None | $125.89 | $162.18 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $162.18 | Professional | None | $85.11 | $87.10 | $162.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $12.02 | Professional | RR · Rental | $8.51 | $8.51 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $91.20 | Professional | UE · Used equipment | $63.10 | $63.10 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Facility | None | $229.09 | $229.09 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $162.18 | Facility | None | $89.13 | $89.13 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $776.25 | Professional | None | $64.57 | $89.13 | $776.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $398.11 Median $912.01 Typical High $2,137.96 | Facility | None | $398.11 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $199.53 | Professional | None | $100.00 | $131.83 | $199.53 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $114.82 | Professional | None | $46.77 | $79.43 | $114.82 |
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 $38.90 Median $38.90 Typical High $54.95 | Professional | 52 · Reduced service | $38.90 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $22.39 | Professional | 53 · Discontinued | $15.49 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $16.60 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $10.96 |
Where Indiana sits
The same service costs 2.8 times more in Kansas 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.