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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $42.66 | Professional | None | $30.20 | $30.20 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $63.10 Typical High $66.07 | Facility | None | $48.98 | $63.10 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $63.10 | Professional | None | $33.11 | $34.67 | $63.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $4.68 | Professional | RR · Rental | $3.31 | $3.31 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | UE · Used equipment | $25.12 | $25.12 | $34.67 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $93.33 | Facility | None | $89.13 | $89.13 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $63.10 | Facility | None | $33.88 | $33.88 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $33.88 Typical High $302.00 | Professional | None | $25.12 | $33.88 | $302.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $154.88 Median $912.01 Typical High $2,137.96 | Facility | None | $154.88 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $77.62 | Professional | None | $38.90 | $51.29 | $77.62 |
United Setting Professional Modifier None Typical Low $18.20 Median $30.90 Typical High $44.67 | Professional | None | $18.20 | $30.90 | $44.67 |
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 $15.14 Median $15.14 Typical High $21.38 | Professional | 52 · Reduced service | $15.14 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $8.71 | Professional | 53 · Discontinued | $6.03 | $6.03 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $6.46 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $4.37 |
Where Indiana sits
The same service costs 2.8 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· 34th of 51
$33.88
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.