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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $52.48 | Professional | None | $24.55 | $24.55 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $72.44 | Professional | None | $38.90 | $52.48 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $56.23 | Facility | None | $40.74 | $52.48 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $52.48 | Professional | None | $32.36 | $35.48 | $52.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $4.57 | Professional | RR · Rental | $3.24 | $3.24 | $4.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | UE · Used equipment | $24.55 | $24.55 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $75.86 Typical High $79.43 | Facility | None | $52.48 | $75.86 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $74.13 | Professional | None | $52.48 | $69.18 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $52.48 | Facility | None | $34.67 | $34.67 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $34.67 Typical High $239.88 | Professional | None | $25.70 | $34.67 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $2,187.76 | Facility | None | $77.62 | $165.96 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $74.13 | Professional | None | $33.11 | $43.65 | $74.13 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $14.45 Median $25.70 Typical High $42.66 | Professional | None | $14.45 | $25.70 | $42.66 |
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 $12.30 Median $12.30 Typical High $26.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $10.47 | Professional | 53 · Discontinued | $4.90 | $4.90 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $7.94 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $5.25 |
Where Indiana sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 26th of 51
$32.36
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.