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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $72.44 | Professional | None | $51.29 | $51.29 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $104.71 Typical High $112.20 | Facility | None | $83.18 | $104.71 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $104.71 | Professional | None | $53.70 | $53.70 | $104.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $8.13 | Professional | RR · Rental | $5.37 | $5.37 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $58.88 | Professional | UE · Used equipment | $40.74 | $40.74 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $154.88 | Facility | None | $151.36 | $151.36 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $104.71 | Facility | None | $57.54 | $57.54 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $501.19 | Professional | None | $41.69 | $57.54 | $501.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $257.04 Median $912.01 Typical High $2,137.96 | Facility | None | $257.04 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $128.82 | Professional | None | $66.07 | $87.10 | $128.82 |
United Setting Professional Modifier None Typical Low $30.20 Median $51.29 Typical High $75.86 | Professional | None | $30.20 | $51.29 | $75.86 |
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 $25.70 Median $25.70 Typical High $36.31 | Professional | 52 · Reduced service | $25.70 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $14.45 | Professional | 53 · Discontinued | $10.23 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $10.96 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $7.24 |
Where Indiana sits
The same service costs 2.6 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· 38th of 51
$53.70
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.