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 $39.81 Median $60.26 Typical High $70.79 | Facility | None | $39.81 | $60.26 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $60.26 | Professional | None | $38.90 | $39.81 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $104.71 | Professional | None | $50.12 | $61.66 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $81.28 Typical High $87.10 | Facility | None | $64.57 | $81.28 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $81.28 | Professional | None | $39.81 | $39.81 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $3.98 Typical High $5.62 | Professional | RR · Rental | $3.98 | $3.98 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $40.74 | Professional | UE · Used equipment | $30.20 | $30.20 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $100.00 | Facility | None | $66.07 | $95.50 | $100.00 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $93.33 | Professional | None | $66.07 | $85.11 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $50.12 Typical High $81.28 | Facility | None | $45.71 | $50.12 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $380.19 | Professional | None | $33.11 | $45.71 | $380.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $120.23 Median $257.04 Typical High $2,187.76 | Facility | None | $120.23 | $257.04 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $117.49 | Professional | None | $52.48 | $67.61 | $117.49 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Facility | None | $43.65 | $43.65 | $52.48 |
United Setting Professional Modifier None Typical Low $21.88 Median $39.81 Typical High $58.88 | Professional | None | $21.88 | $39.81 | $58.88 |
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 $19.05 Median $19.95 Typical High $22.91 | Professional | 52 · Reduced service | $19.05 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.94 Typical High $9.33 | Professional | 53 · Discontinued | $7.76 | $7.94 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.03 Typical High $6.92 | Professional | 55 · Aftercare only | $5.75 | $6.03 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.98 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.89 | $3.98 | $4.57 |
Where Indiana sits
The same service costs 3.8 times more in Hawaii 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· 43rd of 51
$39.81
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.