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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $89.13 | Professional | None | $41.69 | $41.69 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $89.13 Typical High $95.50 | Facility | None | $70.79 | $89.13 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $89.13 | Professional | None | $47.86 | $48.98 | $89.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $6.76 | Professional | RR · Rental | $4.79 | $4.79 | $6.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $35.48 Typical High $51.29 | Professional | UE · Used equipment | $35.48 | $35.48 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $131.83 | Facility | None | $128.82 | $128.82 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $69.18 Typical High $89.13 | Facility | None | $53.70 | $69.18 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $426.58 | Professional | None | $58.88 | $69.18 | $426.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $134.90 Median $281.84 Typical High $2,187.76 | Facility | None | $134.90 | $281.84 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $125.89 | Professional | None | $56.23 | $74.13 | $125.89 |
United Setting Professional Modifier None Typical Low $26.30 Median $43.65 Typical High $72.44 | Professional | None | $26.30 | $43.65 | $72.44 |
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 $20.89 Median $20.89 Typical High $43.65 | Professional | 52 · Reduced service | $20.89 | $20.89 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $17.78 | Professional | 53 · Discontinued | $8.32 | $8.32 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $13.18 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $8.91 |
Where Indiana sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 47th of 51
$48.98
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.