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 $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $32.36 | Professional | None | $22.91 | $22.91 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $46.77 Typical High $50.12 | Facility | None | $37.15 | $46.77 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $46.77 | Professional | None | $23.99 | $23.99 | $46.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.45 Median $2.45 Typical High $3.47 | Professional | RR · Rental | $2.45 | $2.45 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.20 Median $18.20 Typical High $25.12 | Professional | UE · Used equipment | $18.20 | $18.20 | $25.12 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $69.18 | Facility | None | $67.61 | $67.61 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $46.77 | Facility | None | $26.92 | $26.92 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $26.92 Typical High $223.87 | Professional | None | $19.95 | $26.92 | $223.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $114.82 Median $912.01 Typical High $2,137.96 | Facility | None | $114.82 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $29.51 Median $38.90 Typical High $57.54 | Professional | None | $29.51 | $38.90 | $57.54 |
United Setting Professional Modifier None Typical Low $13.80 Median $22.91 Typical High $33.88 | Professional | None | $13.80 | $22.91 | $33.88 |
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 $11.48 Median $11.48 Typical High $16.22 | Professional | 52 · Reduced service | $11.48 | $11.48 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $6.46 | Professional | 53 · Discontinued | $4.57 | $4.57 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $4.79 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $3.24 |
Where Indiana sits
The same service costs 2.5 times more in Montana 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· 36th of 51
$23.99
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.