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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $36.31 | Professional | None | $25.70 | $25.70 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $53.70 Typical High $56.23 | Facility | None | $41.69 | $53.70 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $53.70 | Professional | None | $27.54 | $27.54 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $3.89 | Professional | RR · Rental | $2.75 | $2.75 | $3.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $28.84 | Professional | UE · Used equipment | $20.42 | $20.42 | $28.84 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Facility | None | $75.86 | $75.86 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $34.67 Typical High $53.70 | Facility | None | $32.36 | $34.67 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $34.67 Typical High $257.04 | Professional | None | $25.70 | $34.67 | $257.04 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $128.82 Median $912.01 Typical High $2,137.96 | Facility | None | $128.82 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $66.07 | Professional | None | $33.11 | $43.65 | $66.07 |
United Setting Professional Modifier None Typical Low $15.49 Median $25.70 Typical High $38.02 | Professional | None | $15.49 | $25.70 | $38.02 |
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 $12.88 Median $12.88 Typical High $18.20 | Professional | 52 · Reduced service | $12.88 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $7.41 | Professional | 53 · Discontinued | $5.13 | $5.13 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $5.50 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $3.63 |
Where Indiana sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 33rd of 51
$27.54
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.