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 $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $6.03 | Professional | None | $4.57 | $4.57 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $239.88 | Facility | None | $125.89 | $125.89 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.91 Median $125.89 Typical High $154.88 | Professional | None | $8.91 | $125.89 | $154.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $17.78 | Professional | RR · Rental | $12.59 | $12.59 | $17.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $131.83 | Professional | UE · Used equipment | $93.33 | $93.33 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $309.03 Typical High $436.52 | Facility | None | $239.88 | $309.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $10.00 | Facility | None | $9.33 | $9.33 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $18.20 | Professional | None | $6.76 | $6.76 | $18.20 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $245.47 | Professional | None | $7.08 | $7.08 | $245.47 |
United Setting Professional Modifier None Typical Low $3.98 Median $6.03 Typical High $10.00 | Professional | None | $3.98 | $6.03 | $10.00 |
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 $2.29 Median $2.29 Typical High $3.02 | Professional | 52 · Reduced service | $2.29 | $2.29 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.91 Typical High $1.23 | Professional | 53 · Discontinued | $0.91 | $0.91 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.91 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $0.62 |
Where Indiana sits
The same service costs 39.8 times more in New York than in Hawaii. 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· 2nd of 51
$112
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.