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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $87.10 | Professional | None | $38.02 | $38.02 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $81.28 Typical High $91.20 | Facility | None | $64.57 | $81.28 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $81.28 | Professional | None | $52.48 | $53.70 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $7.41 | Professional | RR · Rental | $5.25 | $5.25 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | UE · Used equipment | $38.90 | $38.90 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Facility | None | $125.89 | $125.89 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $81.28 | Facility | None | $51.29 | $51.29 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $446.68 | Professional | None | $38.02 | $51.29 | $446.68 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $912.01 Typical High $2,137.96 | Facility | None | $199.53 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $100.00 | Professional | None | $51.29 | $67.61 | $100.00 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Facility | None | $53.70 | $53.70 | $64.57 |
United Setting Professional Modifier None Typical Low $26.30 Median $39.81 Typical High $66.07 | Professional | None | $26.30 | $39.81 | $66.07 |
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 $19.05 Median $19.05 Typical High $43.65 | Professional | 52 · Reduced service | $19.05 | $19.05 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $17.38 | Professional | 53 · Discontinued | $7.59 | $7.59 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $13.18 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $8.71 |
Where Indiana sits
The same service costs 4.9 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· 30th of 51
$52.48
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.