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 $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $7.24 Typical High $7.24 | Professional | None | $4.47 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $0.71 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.47 | $0.72 | $0.72 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $13.49 | Facility | None | $7.08 | $7.08 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $9.33 | Professional | None | $7.08 | $7.08 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $41.69 | Professional | None | $7.41 | $7.41 | $41.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,290.87 | Facility | None | $912.01 | $2,089.30 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1.86 Median $7.76 Typical High $9.33 | Professional | None | $1.86 | $7.76 | $9.33 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.13 Typical High $9.33 | Professional | None | $3.72 | $5.13 | $9.33 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | UE · Used equipment | $5.25 | $5.25 | $7.08 |
Where Indiana sits
The same service costs 3.2 times more in Minnesota 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· 36th of 51
$7.08
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.