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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | None | $63.10 | $63.10 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $128.82 Typical High $138.04 | Facility | None | $102.33 | $128.82 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $128.82 | Professional | None | $66.07 | $66.07 | $128.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $9.33 | Professional | RR · Rental | $6.61 | $6.61 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | UE · Used equipment | $50.12 | $50.12 | $69.18 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $190.55 | Facility | None | $186.21 | $186.21 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $128.82 | Facility | None | $70.79 | $70.79 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $616.60 | Professional | None | $51.29 | $70.79 | $616.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $316.23 Median $912.01 Typical High $2,137.96 | Facility | None | $316.23 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $158.49 | Professional | None | $81.28 | $107.15 | $158.49 |
United Setting Professional Modifier None Typical Low $38.02 Median $63.10 Typical High $93.33 | Professional | None | $38.02 | $63.10 | $93.33 |
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 $31.62 Median $31.62 Typical High $44.67 | Professional | 52 · Reduced service | $31.62 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $17.78 | Professional | 53 · Discontinued | $12.59 | $12.59 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $13.49 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $8.91 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii 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
$66.07
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.