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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $91.20 | Professional | None | $43.65 | $43.65 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $93.33 Typical High $97.72 | Facility | None | $72.44 | $93.33 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $93.33 | Professional | None | $54.95 | $54.95 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $7.76 | Professional | RR · Rental | $5.50 | $5.50 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | UE · Used equipment | $40.74 | $40.74 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $138.04 | Facility | None | $131.83 | $131.83 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $93.33 | Facility | None | $50.12 | $50.12 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $50.12 Typical High $446.68 | Professional | None | $37.15 | $50.12 | $446.68 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $138.04 Median $295.12 Typical High $2,187.76 | Facility | None | $138.04 | $295.12 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $131.83 | Professional | None | $58.88 | $77.62 | $131.83 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $26.92 Median $45.71 Typical High $75.86 | Professional | None | $26.92 | $45.71 | $75.86 |
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 $21.38 Median $21.38 Typical High $45.71 | Professional | 52 · Reduced service | $21.38 | $21.38 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $18.20 | Professional | 53 · Discontinued | $8.71 | $8.71 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $13.80 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $9.12 |
Where Indiana sits
The same service costs 2.8 times more in Kansas 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· 32nd of 51
$54.95
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.