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 $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
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 $120.23 Median $120.23 Typical High $204.17 | Professional | None | $120.23 | $120.23 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $12.02 Typical High $16.98 | Professional | RR · Rental | $11.48 | $12.02 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $89.13 Typical High $120.23 | Professional | UE · Used equipment | $87.10 | $89.13 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $302.00 | Facility | None | $204.17 | $295.12 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $281.84 | Professional | None | $204.17 | $263.03 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $141.25 Typical High $204.17 | Facility | None | $125.89 | $141.25 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $977.24 | Professional | None | $93.33 | $125.89 | $977.24 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $15.85 | Professional | RR · Rental | $10.72 | $10.72 | $15.85 |
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 $144.54 Median $173.78 Typical High $295.12 | Professional | None | $144.54 | $173.78 | $295.12 |
United Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $158.49 | Professional | None | $60.26 | $100.00 | $158.49 |
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 2.1 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· 31st of 51
$120
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.