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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $17.78 Typical High $17.78 | Professional | None | $11.75 | $17.78 | $17.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $18.20 | Facility | None | $9.33 | $9.33 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $20.89 | Professional | None | $9.33 | $9.33 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.93 Median $0.93 Typical High $1.38 | Professional | RR · Rental | $0.93 | $0.93 | $1.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.08 Median $7.08 Typical High $10.23 | Professional | UE · Used equipment | $7.08 | $7.08 | $10.23 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.90 | Facility | None | $30.20 | $30.20 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $13.18 | Facility | None | $12.30 | $12.30 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $12.30 Typical High $97.72 | Professional | None | $10.47 | $12.30 | $97.72 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $63.10 Median $912.01 Typical High $2,187.76 | Facility | None | $63.10 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $12.59 Median $16.60 Typical High $26.30 | Professional | None | $12.59 | $16.60 | $26.30 |
United Setting Professional Modifier None Typical Low $5.89 Median $10.23 Typical High $17.38 | Professional | None | $5.89 | $10.23 | $17.38 |
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 $1.74 Median $2.63 Typical High $2.63 | Professional | 55 · Aftercare only | $1.74 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.15 | $1.78 | $1.78 |
Where Indiana sits
The same service costs 3.0 times more in Hawaii 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· 39th of 51
$10.47
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.