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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $85.11 | Professional | None | $37.15 | $37.15 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $79.43 Typical High $89.13 | Facility | None | $63.10 | $79.43 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $79.43 | Professional | None | $51.29 | $51.29 | $79.43 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.13 Median $5.13 Typical High $7.24 | Professional | RR · Rental | $5.13 | $5.13 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $52.48 | Professional | UE · Used equipment | $38.02 | $38.02 | $52.48 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $128.82 | Facility | None | $123.03 | $123.03 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $79.43 | Facility | None | $50.12 | $50.12 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $50.12 Typical High $426.58 | Professional | None | $37.15 | $50.12 | $426.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $194.98 Median $912.01 Typical High $2,137.96 | Facility | None | $194.98 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $97.72 | Professional | None | $50.12 | $66.07 | $97.72 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $38.90 | Facility | None | $32.36 | $32.36 | $38.90 |
United Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $64.57 | Professional | None | $25.70 | $38.90 | $64.57 |
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 $18.62 Median $18.62 Typical High $42.66 | Professional | 52 · Reduced service | $18.62 | $18.62 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $16.98 | Professional | 53 · Discontinued | $7.41 | $7.41 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $12.88 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $8.51 |
Where Indiana sits
The same service costs 2.1 times more in Arkansas than in Colorado. 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· 32nd of 51
$51.29
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.