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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $17.78 | Professional | None | $14.45 | $14.45 | $17.78 |
Ambetter Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $131.83 | Facility | None | $67.61 | $67.61 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $67.61 Typical High $85.11 | Professional | None | $35.48 | $67.61 | $85.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.76 Typical High $9.55 | Professional | RR · Rental | $6.76 | $6.76 | $9.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $72.44 | Professional | UE · Used equipment | $51.29 | $51.29 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $269.15 | Facility | None | $147.91 | $194.98 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Facility | None | $54.95 | $54.95 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $54.95 Typical High $144.54 | Professional | None | $39.81 | $54.95 | $144.54 |
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 $6.46 Median $27.54 Typical High $245.47 | Professional | None | $6.46 | $27.54 | $245.47 |
United Setting Professional Modifier None Typical Low $12.88 Median $19.50 Typical High $30.90 | Professional | None | $12.88 | $19.50 | $30.90 |
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 $7.24 Median $7.24 Typical High $8.91 | Professional | 52 · Reduced service | $7.24 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $3.55 | Professional | 53 · Discontinued | $2.88 | $2.88 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.69 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.78 |
Where Indiana sits
The same service costs 8.9 times more in North Dakota 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· 6th of 51
$67.61
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.