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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $26.92 | Professional | None | $19.05 | $19.05 | $26.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $38.90 Typical High $41.69 | Facility | None | $30.90 | $38.90 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $38.90 | Professional | None | $20.89 | $20.89 | $38.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.04 Median $2.04 Typical High $2.95 | Professional | RR · Rental | $2.04 | $2.04 | $2.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | UE · Used equipment | $15.49 | $15.49 | $21.38 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $57.54 | Facility | None | $56.23 | $56.23 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $38.90 | Facility | None | $21.38 | $21.38 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $21.38 Typical High $186.21 | Professional | None | $15.49 | $21.38 | $186.21 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $95.50 Median $912.01 Typical High $2,137.96 | Facility | None | $95.50 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $24.55 Median $32.36 Typical High $47.86 | Professional | None | $24.55 | $32.36 | $47.86 |
United Setting Professional Modifier None Typical Low $11.48 Median $19.05 Typical High $28.18 | Professional | None | $11.48 | $19.05 | $28.18 |
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 $9.55 Median $9.55 Typical High $13.49 | Professional | 52 · Reduced service | $9.55 | $9.55 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $5.37 | Professional | 53 · Discontinued | $3.80 | $3.80 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $4.07 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $2.69 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $2.69 |
Where Indiana sits
The same service costs 3.1 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· 29th of 51
$20.89
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.