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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $61.66 | Professional | None | $33.11 | $33.11 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $70.79 Typical High $75.86 | Facility | None | $56.23 | $70.79 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $70.79 | Professional | None | $38.90 | $38.90 | $70.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $3.89 Typical High $5.50 | Professional | RR · Rental | $3.89 | $3.89 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | UE · Used equipment | $29.51 | $29.51 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $91.20 | Facility | None | $89.13 | $89.13 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $70.79 | Facility | None | $44.67 | $44.67 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $44.67 Typical High $346.74 | Professional | None | $33.11 | $44.67 | $346.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $912.01 Typical High $2,137.96 | Facility | None | $173.78 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $44.67 Median $58.88 Typical High $87.10 | Professional | None | $44.67 | $58.88 | $87.10 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $37.15 | Facility | None | $36.31 | $36.31 | $37.15 |
United Setting Professional Modifier None Typical Low $20.42 Median $34.67 Typical High $57.54 | Professional | None | $20.42 | $34.67 | $57.54 |
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 $16.60 Median $16.60 Typical High $30.90 | Professional | 52 · Reduced service | $16.60 | $16.60 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $12.30 | Professional | 53 · Discontinued | $6.61 | $6.61 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $9.12 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $6.17 |
Where Indiana sits
The same service costs 2.5 times more in Hawaii 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· 37th of 51
$38.90
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.