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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | None | $194.98 | $194.98 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $436.52 Typical High $467.74 | Facility | None | $346.74 | $436.52 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $436.52 | Professional | None | $245.47 | $251.19 | $436.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $34.67 | Professional | RR · Rental | $24.55 | $24.55 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $186.21 Typical High $263.03 | Professional | UE · Used equipment | $186.21 | $186.21 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $630.96 | Facility | None | $616.60 | $616.60 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $436.52 | Facility | None | $263.03 | $263.03 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $2,344.23 | Professional | None | $194.98 | $263.03 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $645.65 Median $1,096.48 Typical High $2,187.76 | Facility | None | $645.65 | $1,096.48 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $616.60 | Professional | None | $275.42 | $363.08 | $616.60 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Facility | None | $213.80 | $213.80 | $275.42 |
United Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $323.59 | Professional | None | $138.04 | $213.80 | $323.59 |
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 $107.15 Median $107.15 Typical High $147.91 | Professional | 52 · Reduced service | $107.15 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | 53 · Discontinued | $42.66 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $44.67 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $29.51 |
Where Indiana sits
The same service costs 4.7 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· 36th of 51
$245
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.