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 $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $22.91 | Professional | None | $8.91 | $8.91 | $22.91 |
Ambetter Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $19.05 | Professional | None | $14.45 | $14.45 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $19.05 Typical High $23.99 | Facility | None | $15.14 | $19.05 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $14.13 Typical High $20.89 | Professional | None | $13.49 | $14.13 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.35 Median $1.35 Typical High $1.91 | Professional | RR · Rental | $1.35 | $1.35 | $1.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $10.23 Typical High $14.13 | Professional | UE · Used equipment | $10.23 | $10.23 | $14.13 |
CareSource Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.88 | Facility | None | $33.11 | $33.11 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $19.05 | Facility | None | $14.45 | $14.45 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $14.45 Typical High $107.15 | Professional | None | $10.47 | $14.45 | $107.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $46.77 Median $912.01 Typical High $2,137.96 | Facility | None | $46.77 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $23.99 | Professional | None | $12.02 | $15.85 | $23.99 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.88 | Facility | None | $12.59 | $12.59 | $12.88 |
United Setting Professional Modifier None Typical Low $6.31 Median $9.33 Typical High $15.85 | Professional | None | $6.31 | $9.33 | $15.85 |
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 $4.47 Median $4.47 Typical High $11.48 | Professional | 52 · Reduced service | $4.47 | $4.47 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.82 Typical High $4.57 | Professional | 53 · Discontinued | $1.82 | $1.82 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.35 Typical High $3.39 | Professional | 55 · Aftercare only | $1.35 | $1.35 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $0.89 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.89 | $0.89 | $2.29 |
Where Indiana sits
The same service costs 3.0 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· 34th of 51
$13.49
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.