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 $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.88 | Professional | None | $10.47 | $10.47 | $12.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $107.15 | Facility | None | $54.95 | $54.95 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $54.95 Typical High $72.44 | Professional | None | $21.38 | $54.95 | $72.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $7.76 | Professional | RR · Rental | $5.50 | $5.50 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | UE · Used equipment | $40.74 | $40.74 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $186.21 Typical High $257.04 | Facility | None | $141.25 | $186.21 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $30.90 | Facility | None | $28.18 | $28.18 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $28.18 Typical High $104.71 | Professional | None | $20.42 | $28.18 | $104.71 |
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 $4.68 Median $19.95 Typical High $245.47 | Professional | None | $4.68 | $19.95 | $245.47 |
United Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $21.88 | Professional | None | $9.33 | $14.13 | $21.88 |
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 $5.25 Median $5.25 Typical High $6.46 | Professional | 52 · Reduced service | $5.25 | $5.25 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.57 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.55 Typical High $1.95 | Professional | 55 · Aftercare only | $1.55 | $1.55 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.29 |
Where Indiana sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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· 3rd of 51
$54.95
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.