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 $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $22.91 Typical High $22.91 | Professional | None | $15.14 | $22.91 | $22.91 |
Ambetter Setting Professional Modifier None Typical Low $4.47 Median $21.88 Typical High $21.88 | Professional | None | $4.47 | $21.88 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $24.55 | Facility | None | $12.88 | $12.88 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $25.70 | Professional | None | $12.88 | $12.88 | $25.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.29 Median $1.29 Typical High $1.70 | Professional | RR · Rental | $1.29 | $1.29 | $1.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.55 Median $9.55 Typical High $12.88 | Professional | UE · Used equipment | $9.55 | $9.55 | $12.88 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $38.02 | Facility | None | $36.31 | $36.31 | $38.02 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $35.48 | Professional | None | $25.12 | $30.20 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $125.89 | Professional | None | $15.14 | $15.14 | $125.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $77.62 Median $912.01 Typical High $2,187.76 | Facility | None | $77.62 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $15.49 Median $19.50 Typical High $41.69 | Professional | None | $15.49 | $19.50 | $41.69 |
United Setting Professional Modifier None Typical Low $8.71 Median $13.18 Typical High $22.39 | Professional | None | $8.71 | $13.18 | $22.39 |
2 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 55 · Aftercare only Typical Low $2.24 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $2.24 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.51 | $2.29 | $2.29 |
Where Indiana sits
The same service costs 2.5 times more in Hawaii than in Colorado. 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· 46th of 51
$14.13
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.