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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $52.48 | Professional | None | $37.15 | $37.15 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $81.28 | Facility | None | $60.26 | $75.86 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $75.86 | Professional | None | $40.74 | $40.74 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $5.75 | Professional | RR · Rental | $4.07 | $4.07 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.90 Median $30.90 Typical High $42.66 | Professional | UE · Used equipment | $30.90 | $30.90 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $112.20 | Facility | None | $109.65 | $109.65 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $75.86 | Facility | None | $41.69 | $41.69 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $363.08 | Professional | None | $30.90 | $41.69 | $363.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $186.21 Median $912.01 Typical High $2,137.96 | Facility | None | $186.21 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $93.33 | Professional | None | $47.86 | $63.10 | $93.33 |
United Setting Professional Modifier None Typical Low $22.39 Median $37.15 Typical High $54.95 | Professional | None | $22.39 | $37.15 | $54.95 |
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 $18.62 Median $18.62 Typical High $26.30 | Professional | 52 · Reduced service | $18.62 | $18.62 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $10.47 | Professional | 53 · Discontinued | $7.41 | $7.41 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $7.94 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $5.25 |
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· 36th of 51
$40.74
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.