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 $0.45 Median $0.52 Typical High $0.74 | Facility | None | $0.45 | $0.52 | $0.74 |
Aetna Setting Professional Modifier None Typical Low $0.30 Median $0.52 Typical High $0.52 | Professional | None | $0.30 | $0.52 | $0.52 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $40.74 | Professional | None | $38.02 | $38.02 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.25 Median $0.25 Typical High $0.48 | Facility | None | $0.25 | $0.25 | $0.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.18 Median $0.37 Typical High $0.63 | Professional | None | $0.18 | $0.37 | $0.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.19 Median $0.25 Typical High $0.26 | Professional | UE · Used equipment | $0.19 | $0.25 | $0.26 |
CareSource Setting Facility Modifier None Typical Low $0.60 Median $0.60 Typical High $1.02 | Facility | None | $0.60 | $0.60 | $1.02 |
CareSource Setting Professional Modifier None Typical Low $0.52 Median $0.60 Typical High $0.71 | Professional | None | $0.52 | $0.60 | $0.71 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $2.95 | Professional | None | $0.31 | $0.31 | $2.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1.86 Median $2.69 Typical High $2,187.76 | Facility | None | $1.86 | $2.69 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.38 Median $0.49 Typical High $1.00 | Professional | None | $0.38 | $0.49 | $1.00 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.30 Typical High $0.51 | Professional | None | $0.17 | $0.30 | $0.51 |
6 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 $0.15 Median $0.27 Typical High $0.27 | Professional | 52 · Reduced service | $0.15 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.06 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.05 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.05 | $0.05 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.03 Typical High $0.17 | Professional | RR · Rental | $0.03 | $0.03 | $0.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.06 Typical High $0.08 | Professional | RR · Rental | $0.05 | $0.06 | $0.08 |
Where Indiana sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 31st of 51
$0.33
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.