How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | None | $0.15 | $0.15 | $0.15 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.14 Median $0.14 Typical High $0.27 | Facility | None | $0.14 | $0.14 | $0.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.10 Median $0.17 Typical High $1.00 | Professional | None | $0.10 | $0.17 | $1.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.11 Median $0.14 Typical High $0.15 | Professional | UE · Used equipment | $0.11 | $0.14 | $0.15 |
CareSource Setting Facility Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Facility | None | $1.91 | $1.91 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $1.86 | Professional | None | $0.30 | $0.30 | $1.86 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.11 Median $0.20 Typical High $0.27 | Professional | None | $0.11 | $0.20 | $0.27 |
United Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $60.26 | Professional | None | $34.67 | $39.81 | $60.26 |
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 $0.08 Median $0.08 Typical High $0.08 | Professional | 52 · Reduced service | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Indiana sits
The same service costs 1318.3 times more in Montana than in Missouri. 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· 35th of 51
$0.17
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.