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 $57.54 Median $87.10 Typical High $102.33 | Facility | None | $57.54 | $87.10 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $83.18 | Professional | None | $57.54 | $57.54 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | None | $75.86 | $75.86 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $120.23 Typical High $125.89 | Facility | None | $93.33 | $120.23 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $120.23 | Professional | None | $61.66 | $63.10 | $120.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $8.71 | Professional | RR · Rental | $6.17 | $6.17 | $8.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | UE · Used equipment | $45.71 | $45.71 | $63.10 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $169.82 Typical High $177.83 | Facility | None | $117.49 | $169.82 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $165.96 | Professional | None | $117.49 | $154.88 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $120.23 | Facility | None | $67.61 | $67.61 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $562.34 | Professional | None | $50.12 | $67.61 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $371.54 Typical High $2,187.76 | Facility | None | $173.78 | $371.54 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $169.82 | Professional | None | $75.86 | $100.00 | $169.82 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $77.62 | Facility | None | $67.61 | $67.61 | $77.62 |
United Setting Professional Modifier None Typical Low $33.88 Median $57.54 Typical High $85.11 | Professional | None | $33.88 | $57.54 | $85.11 |
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 $28.84 Median $28.84 Typical High $41.69 | Professional | 52 · Reduced service | $28.84 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $16.60 | Professional | 53 · Discontinued | $11.48 | $11.48 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $12.30 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $8.32 |
Where Indiana sits
The same service costs 4.1 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· 34th of 51
$63.10
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.