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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $81.28 | Professional | None | $57.54 | $57.54 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $117.49 Typical High $125.89 | Facility | None | $93.33 | $117.49 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $117.49 | Professional | None | $67.61 | $69.18 | $117.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.92 Typical High $9.77 | Professional | RR · Rental | $6.61 | $6.92 | $9.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $52.48 Typical High $74.13 | Professional | UE · Used equipment | $50.12 | $52.48 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $173.78 | Facility | None | $169.82 | $169.82 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $117.49 | Facility | None | $70.79 | $70.79 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $562.34 | Professional | None | $51.29 | $70.79 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $363.08 Typical High $2,187.76 | Facility | None | $173.78 | $363.08 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $169.82 | Professional | None | $74.13 | $97.72 | $169.82 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
United Setting Professional Modifier None Typical Low $34.67 Median $57.54 Typical High $91.20 | Professional | None | $34.67 | $57.54 | $91.20 |
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 $28.84 Median $28.84 Typical High $40.74 | Professional | 52 · Reduced service | $28.84 | $28.84 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.02 Typical High $16.22 | Professional | 53 · Discontinued | $10.96 | $12.02 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $12.30 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $8.13 |
Where Indiana sits
The same service costs 2.4 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· 26th of 51
$69.18
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.