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 $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $6.31 | Professional | None | $3.02 | $3.02 | $6.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.01 Median $6.46 Typical High $6.76 | Facility | None | $5.01 | $6.46 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $6.46 | Professional | None | $3.39 | $3.55 | $6.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.48 | Professional | RR · Rental | $0.34 | $0.34 | $0.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $3.72 | Professional | UE · Used equipment | $2.57 | $2.57 | $3.72 |
CareSource Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.55 | Facility | None | $9.12 | $9.12 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.80 Typical High $6.46 | Facility | None | $3.55 | $3.80 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.80 Typical High $30.90 | Professional | None | $2.95 | $3.80 | $30.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $15.85 Median $912.01 Typical High $2,137.96 | Facility | None | $15.85 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3.98 Median $5.25 Typical High $7.94 | Professional | None | $3.98 | $5.25 | $7.94 |
United Setting Professional Modifier None Typical Low $1.86 Median $3.16 Typical High $5.25 | Professional | None | $1.86 | $3.16 | $5.25 |
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 $1.51 Median $1.51 Typical High $3.16 | Professional | 52 · Reduced service | $1.51 | $1.51 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $1.26 | Professional | 53 · Discontinued | $0.60 | $0.60 | $1.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.95 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.63 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.63 |
Where Indiana sits
The same service costs 4.9 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· 42nd of 51
$3.39
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.