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 $63.10 | Professional | None | $43.65 | $43.65 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $95.50 | Facility | None | $70.79 | $91.20 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $91.20 | Professional | None | $46.77 | $47.86 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $4.68 Typical High $6.92 | Professional | RR · Rental | $4.68 | $4.68 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $50.12 | Professional | UE · Used equipment | $34.67 | $34.67 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Facility | None | $128.82 | $128.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $91.20 | Facility | None | $50.12 | $50.12 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $436.52 | Professional | None | $36.31 | $50.12 | $436.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $134.90 Median $288.40 Typical High $2,187.76 | Facility | None | $134.90 | $288.40 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $128.82 | Professional | None | $57.54 | $75.86 | $128.82 |
United Setting Professional Modifier None Typical Low $26.30 Median $44.67 Typical High $66.07 | Professional | None | $26.30 | $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 $31.62 | Professional | 52 · Reduced service | $21.88 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $12.59 | Professional | 53 · Discontinued | $8.71 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $9.33 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $6.31 |
Where Indiana sits
The same service costs 3.0 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· 37th of 51
$46.77
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.