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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | None | $45.71 | $45.71 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $100.00 | Facility | None | $74.13 | $93.33 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $93.33 | Professional | None | $47.86 | $47.86 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $6.76 | Professional | RR · Rental | $4.79 | $4.79 | $6.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | UE · Used equipment | $36.31 | $36.31 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $138.04 | Facility | None | $134.90 | $134.90 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $93.33 | Facility | None | $57.54 | $57.54 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $446.68 | Professional | None | $41.69 | $57.54 | $446.68 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $912.01 Typical High $2,137.96 | Facility | None | $229.09 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $114.82 | Professional | None | $58.88 | $77.62 | $114.82 |
United Setting Professional Modifier None Typical Low $27.54 Median $45.71 Typical High $67.61 | Professional | None | $27.54 | $45.71 | $67.61 |
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 $22.91 Median $22.91 Typical High $32.36 | Professional | 52 · Reduced service | $22.91 | $22.91 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $12.88 | Professional | 53 · Discontinued | $9.12 | $9.12 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $9.77 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $6.46 |
Where Indiana sits
The same service costs 2.3 times more in Montana than in Florida. 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· 40th of 51
$47.86
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.