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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | None | $45.71 | $45.71 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $100.00 | Facility | None | $74.13 | $95.50 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $95.50 | Professional | None | $48.98 | $51.29 | $95.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $7.41 | Professional | RR · Rental | $4.90 | $4.90 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $40.74 Typical High $48.98 | Professional | UE · Used equipment | $37.15 | $40.74 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Facility | None | $134.90 | $134.90 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $95.50 | Facility | None | $56.23 | $56.23 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $457.09 | Professional | None | $41.69 | $56.23 | $457.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $138.04 Median $295.12 Typical High $2,187.76 | Facility | None | $138.04 | $295.12 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $134.90 | Professional | None | $60.26 | $79.43 | $134.90 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $27.54 Median $46.77 Typical High $69.18 | Professional | None | $27.54 | $46.77 | $69.18 |
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 $22.91 Median $22.91 Typical High $33.11 | Professional | 52 · Reduced service | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $13.18 | Professional | 53 · Discontinued | $9.12 | $9.12 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $9.77 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $6.61 |
Where Indiana sits
The same service costs 2.6 times more in Kansas than in Arizona. 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
$51.29
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.