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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $34.67 | Professional | None | $24.55 | $24.55 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $50.12 Typical High $52.48 | Facility | None | $39.81 | $50.12 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $50.12 | Professional | None | $26.92 | $26.92 | $50.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $3.80 | Professional | RR · Rental | $2.69 | $2.69 | $3.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | UE · Used equipment | $19.95 | $19.95 | $26.92 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $74.13 | Facility | None | $70.79 | $70.79 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $50.12 | Facility | None | $27.54 | $27.54 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $27.54 Typical High $239.88 | Professional | None | $19.95 | $27.54 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $123.03 Median $912.01 Typical High $2,137.96 | Facility | None | $123.03 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $61.66 | Professional | None | $30.90 | $40.74 | $61.66 |
United Setting Professional Modifier None Typical Low $14.45 Median $24.55 Typical High $36.31 | Professional | None | $14.45 | $24.55 | $36.31 |
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 $12.02 Median $12.02 Typical High $17.38 | Professional | 52 · Reduced service | $12.02 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $6.92 | Professional | 53 · Discontinued | $4.79 | $4.79 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $5.13 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $3.47 |
Where Indiana sits
The same service costs 2.6 times more in Montana 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· 36th of 51
$26.92
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.