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 $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $39.81 | Professional | None | $28.18 | $28.18 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $57.54 Typical High $61.66 | Facility | None | $45.71 | $57.54 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $57.54 | Professional | None | $30.90 | $30.90 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $4.37 | Professional | RR · Rental | $3.09 | $3.09 | $4.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $22.91 Typical High $32.36 | Professional | UE · Used equipment | $22.91 | $22.91 | $32.36 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $85.11 | Facility | None | $83.18 | $83.18 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $57.54 | Facility | None | $33.11 | $33.11 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $275.42 | Professional | None | $23.99 | $33.11 | $275.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $141.25 Median $912.01 Typical High $2,137.96 | Facility | None | $141.25 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $70.79 | Professional | None | $36.31 | $47.86 | $70.79 |
United Setting Professional Modifier None Typical Low $16.98 Median $28.18 Typical High $41.69 | Professional | None | $16.98 | $28.18 | $41.69 |
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 $14.13 Median $14.13 Typical High $19.95 | Professional | 52 · Reduced service | $14.13 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $7.94 | Professional | 53 · Discontinued | $5.62 | $5.62 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $6.03 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $3.98 |
Where Indiana sits
The same service costs 2.6 times more in Montana than in Kansas. 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· 38th of 51
$30.90
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.