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 $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $25.70 | Professional | None | $11.75 | $11.75 | $25.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $25.12 Typical High $26.92 | Facility | None | $19.95 | $25.12 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.49 Median $15.85 Typical High $25.12 | Professional | None | $15.49 | $15.85 | $25.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.55 Median $1.55 Typical High $2.19 | Professional | RR · Rental | $1.55 | $1.55 | $2.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.48 Median $11.48 Typical High $16.60 | Professional | UE · Used equipment | $11.48 | $11.48 | $16.60 |
CareSource Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $38.90 | Facility | None | $37.15 | $37.15 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $25.12 | Facility | None | $16.60 | $16.60 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $16.60 Typical High $138.04 | Professional | None | $12.02 | $16.60 | $138.04 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $61.66 Median $912.01 Typical High $2,137.96 | Facility | None | $61.66 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $15.85 Median $20.89 Typical High $30.90 | Professional | None | $15.85 | $20.89 | $30.90 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $16.22 | Facility | None | $12.88 | $12.88 | $16.22 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.30 Typical High $20.89 | Professional | None | $8.32 | $12.30 | $20.89 |
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 $5.89 Median $5.89 Typical High $12.88 | Professional | 52 · Reduced service | $5.89 | $5.89 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $5.13 | Professional | 53 · Discontinued | $2.34 | $2.34 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $3.89 | Professional | 55 · Aftercare only | $1.78 | $1.78 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $2.57 |
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· 38th of 51
$15.49
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.