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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $53.70 | Professional | None | $43.65 | $43.65 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $95.50 | Facility | None | $72.44 | $91.20 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | None | $45.71 | $45.71 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $45.71 | Professional | RR · Rental | $4.57 | $4.57 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | UE · Used equipment | $33.88 | $33.88 | $47.86 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $114.82 | Facility | None | $109.65 | $109.65 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $91.20 | Facility | None | $54.95 | $54.95 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $54.95 Typical High $436.52 | Professional | None | $39.81 | $54.95 | $436.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $223.87 Median $912.01 Typical High $2,137.96 | Facility | None | $223.87 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $112.20 | Professional | None | $56.23 | $74.13 | $112.20 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $25.12 Median $44.67 Typical High $66.07 | Professional | None | $25.12 | $44.67 | $66.07 |
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 $21.88 Median $21.88 Typical High $26.92 | Professional | 52 · Reduced service | $21.88 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $10.72 | Professional | 53 · Discontinued | $8.71 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $7.94 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $5.37 |
Where Indiana sits
The same service costs 3.5 times more in Hawaii than in West Virginia. 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· 38th of 51
$45.71
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.