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 $30.20 | Professional | None | $24.55 | $24.55 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $95.50 | Facility | None | $50.12 | $50.12 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $7.08 | Professional | RR · Rental | $5.01 | $5.01 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $52.48 | Professional | UE · Used equipment | $37.15 | $37.15 | $52.48 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Facility | None | $50.12 | $50.12 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $245.47 | Professional | None | $36.31 | $50.12 | $245.47 |
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 $10.96 Median $46.77 Typical High $245.47 | Professional | None | $10.96 | $46.77 | $245.47 |
United Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $51.29 | Professional | None | $21.88 | $33.11 | $51.29 |
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 $12.30 Median $12.30 Typical High $15.14 | Professional | 52 · Reduced service | $12.30 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $6.03 | Professional | 53 · Discontinued | $4.90 | $4.90 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $4.57 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $3.02 |
Where Indiana sits
The same service costs 4.1 times more in Kansas than in Colorado. 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· 18th of 51
$50.12
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.