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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $56.23 | Professional | None | $38.02 | $38.02 | $56.23 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $83.18 | Facility | None | $61.66 | $77.62 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $77.62 | Professional | None | $45.71 | $47.86 | $77.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $6.61 | Professional | RR · Rental | $4.57 | $4.57 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $47.86 | Professional | UE · Used equipment | $34.67 | $34.67 | $47.86 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Facility | None | $117.49 | $117.49 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $77.62 | Facility | None | $53.70 | $53.70 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $416.87 | Professional | None | $39.81 | $53.70 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $117.49 Median $245.47 Typical High $2,187.76 | Facility | None | $117.49 | $245.47 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $48.98 Median $64.57 Typical High $109.65 | Professional | None | $48.98 | $64.57 | $109.65 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $51.29 | Facility | None | $47.86 | $47.86 | $51.29 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $60.26 | Professional | None | $25.12 | $38.02 | $60.26 |
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 $19.05 Median $19.05 Typical High $28.18 | Professional | 52 · Reduced service | $19.05 | $19.05 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $11.22 | Professional | 53 · Discontinued | $7.59 | $7.59 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $8.51 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $5.62 |
Where Indiana sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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
$45.71
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.