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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $54.95 | Professional | None | $26.30 | $26.30 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $56.23 Typical High $60.26 | Facility | None | $44.67 | $56.23 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $56.23 | Professional | None | $33.11 | $33.11 | $56.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $4.68 | Professional | RR · Rental | $3.31 | $3.31 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $35.48 | Professional | UE · Used equipment | $25.12 | $25.12 | $35.48 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $83.18 | Facility | None | $79.43 | $79.43 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $56.23 | Facility | None | $34.67 | $34.67 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $295.12 | Professional | None | $25.12 | $34.67 | $295.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $138.04 Median $912.01 Typical High $2,137.96 | Facility | None | $138.04 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $69.18 | Professional | None | $35.48 | $46.77 | $69.18 |
United Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $29.51 | Facility | None | $27.54 | $27.54 | $29.51 |
United Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $45.71 | Professional | None | $18.20 | $27.54 | $45.71 |
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 $13.18 Median $13.18 Typical High $27.54 | Professional | 52 · Reduced service | $13.18 | $13.18 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $10.96 | Professional | 53 · Discontinued | $5.25 | $5.25 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $8.32 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $5.50 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $5.50 |
Where Indiana sits
The same service costs 2.5 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· 38th of 51
$33.11
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.