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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $380.19 | Professional | None | $181.97 | $181.97 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $389.05 Typical High $416.87 | Facility | None | $309.03 | $389.05 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $389.05 | Professional | None | $229.09 | $239.88 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | RR · Rental | $22.91 | $22.91 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | UE · Used equipment | $173.78 | $173.78 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $575.44 | Facility | None | $549.54 | $549.54 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $389.05 | Facility | None | $245.47 | $245.47 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $2,089.30 | Professional | None | $181.97 | $245.47 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $467.74 | Professional | None | $245.47 | $316.23 | $467.74 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $245.47 | Facility | None | $190.55 | $190.55 | $245.47 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $316.23 | Professional | None | $125.89 | $190.55 | $316.23 |
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 $91.20 Median $91.20 Typical High $190.55 | Professional | 52 · Reduced service | $91.20 | $91.20 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $75.86 | Professional | 53 · Discontinued | $36.31 | $36.31 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $57.54 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $38.02 |
Where Indiana sits
The same service costs 2.5 times more in Kansas than in Florida. 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· 43rd of 51
$234
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.