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 $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $16.98 | Professional | None | $13.80 | $13.80 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $45.71 | Facility | None | $23.99 | $23.99 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.88 | Professional | None | $23.99 | $23.99 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.40 Median $2.40 Typical High $3.39 | Professional | RR · Rental | $2.40 | $2.40 | $3.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17.78 Median $17.78 Typical High $23.99 | Professional | UE · Used equipment | $17.78 | $17.78 | $23.99 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $95.50 | Facility | None | $52.48 | $69.18 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $30.90 | Facility | None | $28.84 | $28.84 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $28.84 Typical High $138.04 | Professional | None | $20.89 | $28.84 | $138.04 |
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 $6.17 Median $26.30 Typical High $245.47 | Professional | None | $6.17 | $26.30 | $245.47 |
United Setting Professional Modifier None Typical Low $12.30 Median $18.62 Typical High $28.84 | Professional | None | $12.30 | $18.62 | $28.84 |
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 $6.76 Median $6.76 Typical High $8.51 | Professional | 52 · Reduced service | $6.76 | $6.76 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $3.39 | Professional | 53 · Discontinued | $2.75 | $2.75 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.51 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $1.70 |
Where Indiana sits
The same service costs 4.1 times more in Wyoming than in Utah. 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· 22nd of 51
$23.99
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.