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 $1.29 Median $1.29 Typical High $1.29 | Facility | None | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier None Typical Low $0.83 Median $1.29 Typical High $1.29 | Professional | None | $0.83 | $1.29 | $1.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $2.75 | Facility | None | $1.41 | $1.41 | $2.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $7.59 | Professional | None | $1.41 | $1.41 | $7.59 |
Anthem BCBS Setting Professional Modifier KL · Delivered by mail Typical Low $10.47 Median $10.47 Typical High $13.18 | Professional | KL · Delivered by mail | $10.47 | $10.47 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.07 Median $1.07 Typical High $1.62 | Professional | UE · Used equipment | $1.07 | $1.07 | $1.62 |
CareSource Setting Facility Modifier None Typical Low $1.12 Median $2.04 Typical High $2.14 | Facility | None | $1.12 | $2.04 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $13.49 | Professional | None | $1.02 | $1.02 | $13.49 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $10.72 Median $912.01 Typical High $2,137.96 | Facility | None | $10.72 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.89 Median $1.20 Typical High $2.29 | Professional | None | $0.89 | $1.20 | $2.29 |
United Setting Professional Modifier None Typical Low $0.56 Median $0.85 Typical High $10.23 | Professional | None | $0.56 | $0.85 | $10.23 |
3 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 $0.13 Median $0.19 Typical High $0.19 | Professional | 55 · Aftercare only | $0.13 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.08 | $0.13 | $0.13 |
Ambetter Setting Professional Modifier KS · Glucose supply, no insulin Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | KS · Glucose supply, no insulin | $1.12 | $1.12 | $1.12 |
Where Indiana sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 25th of 51
$1.41
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.