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 $3.47 Median $3.72 Typical High $14.45 | Facility | None | $3.47 | $3.72 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $3.72 Typical High $3.72 | Professional | None | $2.24 | $3.72 | $3.72 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Ambetter Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.05 Median $1.05 Typical High $2.04 | Facility | None | $1.05 | $1.05 | $2.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.70 | Professional | None | $1.05 | $1.05 | $1.70 |
Anthem BCBS Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $3.47 Median $3.47 Typical High $4.68 | Professional | AU · Urologic/ostomy supply | $3.47 | $3.47 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.79 Median $0.79 Typical High $1.23 | Professional | UE · Used equipment | $0.79 | $0.79 | $1.23 |
CareSource Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.62 | Facility | None | $5.37 | $5.37 | $5.62 |
CareSource Setting Professional Modifier None Typical Low $3.72 Median $4.47 Typical High $5.25 | Professional | None | $3.72 | $4.47 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $19.95 | Professional | None | $2.24 | $2.24 | $19.95 |
Cigna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.57 Median $4.57 Typical High $5.25 | Professional | AU · Urologic/ostomy supply | $4.57 | $4.57 | $5.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $7.08 Median $954.99 Typical High $2,290.87 | Facility | None | $7.08 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $2.69 Median $3.47 Typical High $6.46 | Professional | AU · Urologic/ostomy supply | $2.69 | $3.47 | $6.46 |
United Setting Professional Modifier None Typical Low $1.23 Median $2.19 Typical High $3.63 | Professional | None | $1.23 | $2.19 | $3.63 |
5 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 $1.12 Median $1.86 Typical High $1.86 | Professional | 52 · Reduced service | $1.12 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.76 Typical High $0.76 | Professional | 53 · Discontinued | $0.45 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.33 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.38 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.22 | $0.38 | $0.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.19 Median $0.22 Typical High $0.30 | Professional | RR · Rental | $0.19 | $0.22 | $0.30 |
Where Indiana sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 49th of 51
$1.38
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.