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 $89.13 | Professional | None | $37.15 | $37.15 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $79.43 Typical High $93.33 | Facility | None | $63.10 | $79.43 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $79.43 | Professional | None | $53.70 | $53.70 | $79.43 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $7.59 | Professional | RR · Rental | $5.37 | $5.37 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | UE · Used equipment | $39.81 | $39.81 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Facility | None | $128.82 | $128.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $79.43 | Facility | None | $48.98 | $48.98 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $416.87 | Professional | None | $35.48 | $48.98 | $416.87 |
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 $19.95 Median $19.95 Typical High $39.81 | Facility | None | $19.95 | $19.95 | $39.81 |
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 $44.67 | Professional | 52 · Reduced service | $18.62 | $18.62 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $17.78 | Professional | 53 · Discontinued | $7.41 | $7.41 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $13.49 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $8.91 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $8.91 |
Where Indiana sits
The same service costs 2.8 times more in Montana than in New Jersey. 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· 29th of 51
$53.70
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.