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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $31.62 | Professional | None | $15.14 | $15.14 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $32.36 Typical High $36.31 | Facility | None | $25.70 | $32.36 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $32.36 | Professional | None | $20.89 | $25.12 | $32.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $2.95 | Professional | RR · Rental | $2.09 | $2.09 | $2.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.85 Median $15.85 Typical High $22.39 | Professional | UE · Used equipment | $15.85 | $15.85 | $22.39 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $47.86 | Facility | None | $45.71 | $45.71 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $26.92 Typical High $32.36 | Facility | None | $25.12 | $26.92 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $141.25 | Professional | None | $21.38 | $25.12 | $141.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $48.98 Median $102.33 Typical High $2,187.76 | Facility | None | $48.98 | $102.33 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $20.42 Median $26.92 Typical High $45.71 | Professional | None | $20.42 | $26.92 | $45.71 |
United Setting Professional Modifier None Typical Low $9.33 Median $15.85 Typical High $26.30 | Professional | None | $9.33 | $15.85 | $26.30 |
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 $7.59 Median $7.59 Typical High $15.85 | Professional | 52 · Reduced service | $7.59 | $7.59 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $6.31 | Professional | 53 · Discontinued | $3.02 | $3.02 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $4.79 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $3.16 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $3.16 |
Where Indiana sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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· 26th of 51
$22.39
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.