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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | None | $57.54 | $57.54 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $302.00 | Facility | None | $158.49 | $158.49 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $213.80 | Professional | None | $117.49 | $158.49 | $213.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $23.44 | Professional | RR · Rental | $15.85 | $15.85 | $23.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $169.82 | Professional | UE · Used equipment | $117.49 | $117.49 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $407.38 Typical High $562.34 | Facility | None | $309.03 | $407.38 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Facility | None | $56.23 | $56.23 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $575.44 | Professional | None | $41.69 | $56.23 | $575.44 |
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 $26.30 Median $112.20 Typical High $245.47 | Professional | None | $26.30 | $112.20 | $245.47 |
United Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $123.03 | Professional | None | $52.48 | $77.62 | $123.03 |
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 $28.84 Median $28.84 Typical High $35.48 | Professional | 52 · Reduced service | $28.84 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $14.45 | Professional | 53 · Discontinued | $11.48 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $10.72 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $7.24 |
Where Indiana sits
The same service costs 4.9 times more in North Dakota than in Delaware. 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· 6th of 51
$158
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.