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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $114.82 | Professional | None | $53.70 | $53.70 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $114.82 Typical High $123.03 | Facility | None | $91.20 | $114.82 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $114.82 | Professional | None | $61.66 | $61.66 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $8.71 | Professional | RR · Rental | $6.17 | $6.17 | $8.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | UE · Used equipment | $45.71 | $45.71 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $169.82 | Facility | None | $165.96 | $165.96 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $97.72 Typical High $114.82 | Facility | None | $91.20 | $97.72 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $562.34 | Professional | None | $77.62 | $81.28 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $281.84 Median $912.01 Typical High $2,137.96 | Facility | None | $281.84 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $144.54 | Professional | None | $72.44 | $95.50 | $144.54 |
United Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $95.50 | Professional | None | $33.88 | $56.23 | $95.50 |
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 $26.92 Median $26.92 Typical High $57.54 | Professional | 52 · Reduced service | $26.92 | $26.92 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $22.91 | Professional | 53 · Discontinued | $10.96 | $10.96 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $16.98 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $11.48 |
Where Indiana sits
The same service costs 1.9 times more in Montana than in Virginia. 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
$61.66
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.