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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $223.87 | Professional | None | $112.20 | $112.20 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $257.04 | Facility | None | $190.55 | $239.88 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $239.88 | Professional | None | $134.90 | $134.90 | $239.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $19.05 | Professional | RR · Rental | $13.49 | $13.49 | $19.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | UE · Used equipment | $100.00 | $100.00 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Facility | None | $323.59 | $323.59 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $239.88 | Facility | None | $138.04 | $138.04 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $1,230.27 | Professional | None | $102.33 | $138.04 | $1,230.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $588.84 Median $912.01 Typical High $2,137.96 | Facility | None | $588.84 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $288.40 | Professional | None | $151.36 | $199.53 | $288.40 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
United Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $194.98 | Professional | None | $74.13 | $117.49 | $194.98 |
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 $56.23 Median $56.23 Typical High $112.20 | Professional | 52 · Reduced service | $56.23 | $56.23 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $44.67 | Professional | 53 · Discontinued | $22.39 | $22.39 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $33.11 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $22.39 |
Where Indiana sits
The same service costs 3.5 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· 39th of 51
$135
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.