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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $35.48 | Professional | None | $25.12 | $25.12 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $51.29 Typical High $54.95 | Facility | None | $40.74 | $51.29 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $51.29 | Professional | None | $27.54 | $27.54 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $3.89 | Professional | RR · Rental | $2.75 | $2.75 | $3.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $30.20 | Professional | UE · Used equipment | $20.42 | $20.42 | $30.20 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $75.86 | Facility | None | $74.13 | $74.13 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $51.29 | Facility | None | $33.88 | $33.88 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $245.47 | Professional | None | $24.55 | $33.88 | $245.47 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $125.89 Median $912.01 Typical High $2,137.96 | Facility | None | $125.89 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $32.36 Median $42.66 Typical High $63.10 | Professional | None | $32.36 | $42.66 | $63.10 |
United Setting Professional Modifier None Typical Low $15.14 Median $25.12 Typical High $37.15 | Professional | None | $15.14 | $25.12 | $37.15 |
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 $12.59 Median $12.59 Typical High $17.78 | Professional | 52 · Reduced service | $12.59 | $12.59 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $7.08 | Professional | 53 · Discontinued | $5.01 | $5.01 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $5.37 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $3.55 |
Where Indiana sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 34th of 51
$27.54
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.