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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $229.09 | Professional | None | $123.03 | $123.03 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $263.03 Typical High $281.84 | Facility | None | $208.93 | $263.03 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $263.03 | Professional | None | $138.04 | $138.04 | $263.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $19.50 | Professional | RR · Rental | $13.80 | $13.80 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | UE · Used equipment | $102.33 | $102.33 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Facility | None | $331.13 | $331.13 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $263.03 | Facility | None | $173.78 | $173.78 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $1,148.15 | Professional | None | $128.82 | $173.78 | $1,148.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $645.65 Median $912.01 Typical High $2,137.96 | Facility | None | $645.65 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $316.23 | Professional | None | $165.96 | $218.78 | $316.23 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $109.65 | Facility | None | $85.11 | $85.11 | $109.65 |
United Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $213.80 | Professional | None | $69.18 | $128.82 | $213.80 |
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 $61.66 Median $61.66 Typical High $114.82 | Professional | 52 · Reduced service | $61.66 | $61.66 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $45.71 | Professional | 53 · Discontinued | $24.55 | $24.55 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $22.91 |
Where Indiana sits
The same service costs 2.0 times more in Wisconsin 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· 33rd of 51
$138
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.