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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $95.50 | Professional | None | $53.70 | $53.70 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $114.82 Typical High $120.23 | Facility | None | $91.20 | $114.82 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | None | $57.54 | $57.54 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $8.13 | Professional | RR · Rental | $5.75 | $5.75 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $43.65 Median $43.65 Typical High $61.66 | Professional | UE · Used equipment | $43.65 | $43.65 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $114.82 | Facility | None | $60.26 | $60.26 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $537.03 | Professional | None | $43.65 | $60.26 | $537.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $281.84 Median $912.01 Typical High $2,137.96 | Facility | None | $281.84 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $141.25 | Professional | None | $70.79 | $93.33 | $141.25 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Facility | None | $64.57 | $64.57 | $67.61 |
United Setting Professional Modifier None Typical Low $32.36 Median $56.23 Typical High $93.33 | Professional | None | $32.36 | $56.23 | $93.33 |
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 $26.92 Median $26.92 Typical High $47.86 | Professional | 52 · Reduced service | $26.92 | $26.92 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $19.05 | Professional | 53 · Discontinued | $10.72 | $10.72 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $14.45 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $9.55 |
Where Indiana sits
The same service costs 3.6 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· 38th of 51
$57.54
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.