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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $46.77 | Professional | None | $38.90 | $40.74 | $46.77 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $87.10 | Facility | None | $66.07 | $83.18 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $83.18 | Professional | None | $39.81 | $39.81 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $3.98 Typical High $39.81 | Professional | RR · Rental | $3.98 | $3.98 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | UE · Used equipment | $29.51 | $29.51 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Facility | None | $95.50 | $95.50 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $83.18 | Facility | None | $56.23 | $56.23 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $56.23 Typical High $380.19 | Professional | None | $40.74 | $56.23 | $380.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $2,187.76 | Facility | None | $125.89 | $263.03 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $117.49 | Professional | None | $52.48 | $69.18 | $117.49 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $21.88 Median $40.74 Typical High $60.26 | Professional | None | $21.88 | $40.74 | $60.26 |
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 $19.50 Median $19.95 Typical High $23.44 | Professional | 52 · Reduced service | $19.50 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.13 Typical High $9.33 | Professional | 53 · Discontinued | $7.76 | $8.13 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.03 Typical High $6.92 | Professional | 55 · Aftercare only | $5.75 | $6.03 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.07 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.89 | $4.07 | $4.68 |
Where Indiana sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 46th of 51
$40.74
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.