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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $141.25 | Professional | None | $100.00 | $100.00 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $218.78 | Facility | None | $162.18 | $204.17 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $204.17 | Professional | None | $109.65 | $112.20 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.96 Median $10.96 Typical High $15.49 | Professional | RR · Rental | $10.96 | $10.96 | $15.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | UE · Used equipment | $81.28 | $81.28 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $302.00 | Facility | None | $295.12 | $295.12 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $125.89 Typical High $204.17 | Facility | None | $112.20 | $125.89 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $977.24 | Professional | None | $83.18 | $112.20 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $309.03 Median $660.69 Typical High $2,187.76 | Facility | None | $309.03 | $660.69 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $288.40 | Professional | None | $131.83 | $173.78 | $288.40 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $147.91 | Professional | None | $60.26 | $100.00 | $147.91 |
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 $50.12 Median $50.12 Typical High $70.79 | Professional | 52 · Reduced service | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $28.18 | Professional | 53 · Discontinued | $19.95 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $14.13 |
Where Indiana sits
The same service costs 2.3 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· 35th of 51
$112
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.