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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $17.78 | Professional | None | $14.13 | $14.13 | $17.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $125.89 | Facility | None | $66.07 | $66.07 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $66.07 Typical High $87.10 | Professional | None | $35.48 | $66.07 | $87.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $9.33 | Professional | RR · Rental | $6.61 | $6.61 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | UE · Used equipment | $48.98 | $48.98 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $11.48 | Facility | None | $10.72 | $10.72 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $11.48 | Professional | None | $7.76 | $7.76 | $11.48 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $7.08 Median $7.08 Typical High $8.91 | Professional | 52 · Reduced service | $7.08 | $7.08 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $3.55 | Professional | 53 · Discontinued | $2.82 | $2.82 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.69 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $1.78 |
Where Indiana sits
The same service costs 27.5 times more in Kansas than in South Carolina. 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· 5th of 51
$66.07
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.