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 $30.20 Median $30.20 Typical High $52.48 | Facility | None | $30.20 | $30.20 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $30.20 | Professional | None | $19.95 | $30.20 | $30.20 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $30.90 | Facility | None | $15.85 | $15.85 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $36.31 | Professional | None | $15.85 | $15.85 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.58 Median $1.58 Typical High $2.40 | Professional | RR · Rental | $1.58 | $1.58 | $2.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.02 Median $12.02 Typical High $17.78 | Professional | UE · Used equipment | $12.02 | $12.02 | $17.78 |
CareSource Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $52.48 | Facility | None | $51.29 | $51.29 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $22.91 | Facility | None | $21.38 | $21.38 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $165.96 | Professional | None | $18.20 | $20.89 | $165.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $109.65 Median $912.01 Typical High $2,187.76 | Facility | None | $109.65 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $21.38 Median $28.18 Typical High $44.67 | Professional | None | $21.38 | $28.18 | $44.67 |
United Setting Professional Modifier None Typical Low $10.00 Median $17.78 Typical High $29.51 | Professional | None | $10.00 | $17.78 | $29.51 |
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 $2.95 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $2.95 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.00 | $3.02 | $3.02 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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
$18.20
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.