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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $30.20 | Professional | None | $12.02 | $12.02 | $30.20 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $19.95 | Professional | None | $19.05 | $19.95 | $19.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.42 Median $25.70 Typical High $31.62 | Facility | None | $20.42 | $25.70 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $27.54 | Professional | None | $17.78 | $18.62 | $27.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $2.51 | Professional | RR · Rental | $1.82 | $1.82 | $2.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | UE · Used equipment | $13.49 | $13.49 | $18.62 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $44.67 | Facility | None | $43.65 | $43.65 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $25.70 | Facility | None | $16.22 | $16.22 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $131.83 | Professional | None | $12.02 | $16.22 | $131.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $63.10 Median $912.01 Typical High $2,137.96 | Facility | None | $63.10 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $16.22 Median $21.38 Typical High $31.62 | Professional | None | $16.22 | $21.38 | $31.62 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $15.49 | Facility | None | $12.88 | $12.88 | $15.49 |
United Setting Professional Modifier None Typical Low $7.76 Median $12.59 Typical High $20.89 | Professional | None | $7.76 | $12.59 | $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 $6.03 Median $6.03 Typical High $15.14 | Professional | 52 · Reduced service | $6.03 | $6.03 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $6.03 | Professional | 53 · Discontinued | $2.40 | $2.40 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $4.47 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $3.02 |
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· 24th of 51
$17.78
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.