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 $52.48 Median $52.48 Typical High $72.44 | Facility | None | $52.48 | $52.48 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $77.62 | Professional | None | $52.48 | $52.48 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $89.13 Typical High $162.18 | Professional | None | $30.20 | $89.13 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $107.15 Typical High $114.82 | Facility | None | $85.11 | $107.15 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $107.15 | Professional | None | $57.54 | $66.07 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $6.61 Typical High $9.77 | Professional | RR · Rental | $5.62 | $6.61 | $9.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $48.98 Typical High $70.79 | Professional | UE · Used equipment | $42.66 | $48.98 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $138.04 Typical High $144.54 | Facility | None | $95.50 | $138.04 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $134.90 | Professional | None | $95.50 | $125.89 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $67.61 Typical High $107.15 | Facility | None | $61.66 | $67.61 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $501.19 | Professional | None | $44.67 | $61.66 | $501.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $158.49 Median $338.84 Typical High $2,187.76 | Facility | None | $158.49 | $338.84 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $154.88 | Professional | None | $69.18 | $89.13 | $154.88 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $31.62 Median $52.48 Typical High $83.18 | Professional | None | $31.62 | $52.48 | $83.18 |
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 $26.30 Median $26.30 Typical High $33.88 | Professional | 52 · Reduced service | $26.30 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $13.49 | Professional | 53 · Discontinued | $10.47 | $10.47 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $10.00 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $6.76 |
Where Indiana sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 28th 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.