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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Professional | None | $50.12 | $50.12 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $109.65 | Facility | None | $81.28 | $102.33 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $102.33 | Professional | None | $50.12 | $57.54 | $102.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.75 Typical High $8.13 | Professional | RR · Rental | $5.01 | $5.75 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $43.65 Typical High $60.26 | Professional | UE · Used equipment | $38.02 | $43.65 | $60.26 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $138.04 | Facility | None | $134.90 | $134.90 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $102.33 | Facility | None | $53.70 | $53.70 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $478.63 | Professional | None | $38.90 | $53.70 | $478.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $154.88 Median $323.59 Typical High $2,187.76 | Facility | None | $154.88 | $323.59 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $144.54 | Professional | None | $64.57 | $85.11 | $144.54 |
United Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $39.81 | Facility | None | $16.98 | $16.98 | $39.81 |
United Setting Professional Modifier None Typical Low $28.84 Median $50.12 Typical High $77.62 | Professional | None | $28.84 | $50.12 | $77.62 |
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 $24.55 Median $24.55 Typical High $32.36 | Professional | 52 · Reduced service | $24.55 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $10.00 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $9.77 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $6.46 |
Where Indiana sits
The same service costs 3.3 times more in Hawaii 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· 24th of 51
$57.54
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.