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 $77.62 | Professional | None | $52.48 | $52.48 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $64.57 Median $66.07 Typical High $107.15 | Professional | None | $64.57 | $66.07 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $6.46 Typical High $9.12 | Professional | RR · Rental | $6.46 | $6.46 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $72.44 | Professional | UE · Used equipment | $47.86 | $47.86 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $165.96 | Facility | None | $158.49 | $158.49 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $107.15 | Facility | None | $69.18 | $69.18 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $630.96 | Professional | None | $50.12 | $69.18 | $630.96 |
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 $69.18 Median $89.13 Typical High $154.88 | Professional | None | $69.18 | $89.13 | $154.88 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Facility | None | $70.79 | $70.79 | $83.18 |
United Setting Professional Modifier None Typical Low $35.48 Median $52.48 Typical High $83.18 | Professional | None | $35.48 | $52.48 | $83.18 |
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 $26.30 Median $26.30 Typical High $38.90 | Professional | 52 · Reduced service | $26.30 | $26.30 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $15.49 | Professional | 53 · Discontinued | $10.47 | $10.47 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $11.48 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $7.76 |
Where Indiana sits
The same service costs 4.4 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· 36th of 51
$64.57
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.