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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $85.11 | Professional | None | $58.88 | $58.88 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $123.03 Typical High $128.82 | Facility | None | $95.50 | $123.03 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $123.03 | Professional | None | $69.18 | $69.18 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $9.77 | Professional | RR · Rental | $6.92 | $6.92 | $9.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $74.13 | Professional | UE · Used equipment | $52.48 | $52.48 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $181.97 | Facility | None | $173.78 | $173.78 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $123.03 | Facility | None | $85.11 | $85.11 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $630.96 | Professional | None | $61.66 | $85.11 | $630.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $181.97 Median $389.05 Typical High $2,187.76 | Facility | None | $181.97 | $389.05 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $173.78 | Professional | None | $77.62 | $102.33 | $173.78 |
United Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $64.57 | Facility | None | $48.98 | $48.98 | $64.57 |
United Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $91.20 | Professional | None | $38.02 | $60.26 | $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 $29.51 Median $29.51 Typical High $41.69 | Professional | 52 · Reduced service | $29.51 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $16.98 | Professional | 53 · Discontinued | $11.75 | $11.75 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $12.59 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $8.51 |
Where Indiana sits
The same service costs 2.2 times more in Hawaii than in Alabama. 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· 33rd 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.