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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | None | $45.71 | $45.71 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $100.00 | Facility | None | $74.13 | $93.33 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $93.33 | Professional | None | $48.98 | $48.98 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $7.41 | Professional | RR · Rental | $4.90 | $4.90 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | UE · Used equipment | $37.15 | $37.15 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $138.04 | Facility | None | $134.90 | $134.90 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $67.61 Typical High $93.33 | Facility | None | $61.66 | $67.61 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $446.68 | Professional | None | $44.67 | $61.66 | $446.68 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $141.25 Median $288.40 Typical High $2,187.76 | Facility | None | $141.25 | $288.40 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $134.90 | Professional | None | $58.88 | $77.62 | $134.90 |
United Setting Professional Modifier None Typical Low $27.54 Median $45.71 Typical High $74.13 | Professional | None | $27.54 | $45.71 | $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 $22.91 Median $22.91 Typical High $32.36 | Professional | 52 · Reduced service | $22.91 | $22.91 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $12.88 | Professional | 53 · Discontinued | $9.12 | $9.12 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $9.77 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $6.46 |
Where Indiana sits
The same service costs 2.3 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· 41st of 51
$48.98
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.