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 $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $21.38 Typical High $21.38 | Professional | None | $14.13 | $21.38 | $21.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $20.89 | Facility | None | $10.72 | $10.72 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $25.70 | Professional | None | $10.72 | $10.72 | $25.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.07 Median $1.07 Typical High $1.58 | Professional | RR · Rental | $1.07 | $1.07 | $1.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | UE · Used equipment | $8.13 | $8.13 | $11.75 |
CareSource Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $37.15 | Facility | None | $35.48 | $35.48 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $16.22 | Facility | None | $15.14 | $15.14 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $117.49 | Professional | None | $12.88 | $14.13 | $117.49 |
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 $15.14 Median $20.42 Typical High $31.62 | Professional | None | $15.14 | $20.42 | $31.62 |
United Setting Professional Modifier None Typical Low $7.08 Median $12.59 Typical High $20.89 | Professional | None | $7.08 | $12.59 | $20.89 |
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 $2.14 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $2.14 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.41 | $2.14 | $2.14 |
Where Indiana sits
The same service costs 3.5 times more in Hawaii than in Connecticut. 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· 44th of 51
$12.59
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.