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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $69.18 | Professional | None | $48.98 | $48.98 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $77.62 | Professional | None | $56.23 | $74.13 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $107.15 | Facility | None | $79.43 | $100.00 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $100.00 | Professional | None | $58.88 | $60.26 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.89 Median $5.89 Typical High $8.32 | Professional | RR · Rental | $5.89 | $5.89 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $63.10 | Professional | UE · Used equipment | $44.67 | $44.67 | $63.10 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $141.25 Typical High $147.91 | Facility | None | $97.72 | $141.25 | $147.91 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $138.04 | Professional | None | $97.72 | $125.89 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Facility | None | $72.44 | $72.44 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $588.84 | Professional | None | $52.48 | $72.44 | $588.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $151.36 Median $316.23 Typical High $2,187.76 | Facility | None | $151.36 | $316.23 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $141.25 | Professional | None | $63.10 | $83.18 | $141.25 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $100.00 | Facility | None | $64.57 | $64.57 | $100.00 |
United Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $77.62 | Professional | None | $32.36 | $48.98 | $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 $23.99 Median $23.99 Typical High $33.88 | Professional | 52 · Reduced service | $23.99 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $13.80 | Professional | 53 · Discontinued | $9.77 | $9.77 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $10.23 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $6.92 |
Where Indiana sits
The same service costs 5.0 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· 37th of 51
$58.88
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.