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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $158.49 | Professional | None | $75.86 | $75.86 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $173.78 | Facility | None | $128.82 | $162.18 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $162.18 | Professional | None | $95.50 | $95.50 | $162.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $9.55 Typical High $13.80 | Professional | RR · Rental | $9.55 | $9.55 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $72.44 Median $72.44 Typical High $102.33 | Professional | UE · Used equipment | $72.44 | $72.44 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Facility | None | $229.09 | $229.09 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $162.18 | Facility | None | $100.00 | $100.00 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $891.25 | Professional | None | $72.44 | $100.00 | $891.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $398.11 Median $912.01 Typical High $2,137.96 | Facility | None | $398.11 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $199.53 | Professional | None | $102.33 | $134.90 | $199.53 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $107.15 | Facility | None | $102.33 | $102.33 | $107.15 |
United Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $131.83 | Professional | None | $52.48 | $79.43 | $131.83 |
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 $38.02 Median $38.02 Typical High $79.43 | Professional | 52 · Reduced service | $38.02 | $38.02 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $31.62 | Professional | 53 · Discontinued | $15.14 | $15.14 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $23.99 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $15.85 |
Where Indiana sits
The same service costs 4.1 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· 35th of 51
$95.50
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.