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 $0.56 Median $0.56 Typical High $0.56 | Facility | None | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.56 Typical High $0.56 | Professional | None | $0.36 | $0.56 | $0.56 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $4.07 | Facility | None | $2.14 | $2.14 | $4.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.62 Median $2.14 Typical High $2.40 | Professional | None | $0.62 | $2.14 | $2.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.21 Median $0.21 Typical High $0.27 | Professional | RR · Rental | $0.21 | $0.21 | $0.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.58 Median $1.58 Typical High $2.14 | Professional | UE · Used equipment | $1.58 | $1.58 | $2.14 |
CareSource Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $3.24 | Professional | None | $1.82 | $1.82 | $3.24 |
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 $0.14 Median $0.59 Typical High $245.47 | Professional | None | $0.14 | $0.59 | $245.47 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.40 Typical High $0.69 | Professional | None | $0.28 | $0.40 | $0.69 |
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 $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 $0.04 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.04 | $0.06 | $0.06 |
Where Indiana sits
The same service costs 190.5 times more in Wyoming 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· 5th of 51
$1.82
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.