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 $74.13 | Professional | None | $50.12 | $50.12 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $104.71 Typical High $109.65 | Facility | None | $81.28 | $104.71 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $104.71 | Professional | None | $61.66 | $61.66 | $104.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $9.33 | Professional | RR · Rental | $6.17 | $6.17 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | UE · Used equipment | $46.77 | $46.77 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $158.49 | Facility | None | $154.88 | $154.88 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $104.71 | Facility | None | $66.07 | $66.07 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $562.34 | Professional | None | $48.98 | $66.07 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $154.88 Median $331.13 Typical High $2,187.76 | Facility | None | $154.88 | $331.13 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $147.91 | Professional | None | $66.07 | $87.10 | $147.91 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $61.66 | Facility | None | $46.77 | $46.77 | $61.66 |
United Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $81.28 | Professional | None | $33.88 | $51.29 | $81.28 |
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 $25.12 Median $25.12 Typical High $37.15 | Professional | 52 · Reduced service | $25.12 | $25.12 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $14.79 | Professional | 53 · Discontinued | $10.00 | $10.00 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $11.22 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $7.41 |
Where Indiana sits
The same service costs 2.7 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
$61.66
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.