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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $134.90 | Professional | None | $95.50 | $95.50 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $194.98 Typical High $208.93 | Facility | None | $154.88 | $194.98 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $194.98 | Professional | None | $100.00 | $100.00 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $14.45 | Professional | RR · Rental | $10.00 | $10.00 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | UE · Used equipment | $75.86 | $75.86 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Facility | None | $281.84 | $281.84 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $194.98 | Facility | None | $107.15 | $107.15 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $954.99 | Professional | None | $79.43 | $107.15 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $2,137.96 | Facility | None | $478.63 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $245.47 | Professional | None | $123.03 | $162.18 | $245.47 |
United Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $141.25 | Professional | None | $57.54 | $95.50 | $141.25 |
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 $47.86 Median $47.86 Typical High $67.61 | Professional | 52 · Reduced service | $47.86 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $26.92 | Professional | 53 · Discontinued | $19.05 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $20.42 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $13.49 |
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· 31st of 51
$100
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.