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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $31.62 Typical High $31.62 | Professional | None | $20.89 | $31.62 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $32.36 | Facility | None | $16.60 | $16.60 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $38.02 | Professional | None | $16.60 | $16.60 | $38.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.66 Median $1.66 Typical High $2.51 | Professional | RR · Rental | $1.66 | $1.66 | $2.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.59 Median $12.59 Typical High $18.62 | Professional | UE · Used equipment | $12.59 | $12.59 | $18.62 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $54.95 | Facility | None | $53.70 | $53.70 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $23.44 | Facility | None | $21.88 | $21.88 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $173.78 | Professional | None | $18.62 | $21.88 | $173.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $114.82 Median $912.01 Typical High $2,187.76 | Facility | None | $114.82 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $46.77 | Professional | None | $22.39 | $29.51 | $46.77 |
United Setting Professional Modifier None Typical Low $10.47 Median $18.20 Typical High $30.90 | Professional | None | $10.47 | $18.20 | $30.90 |
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 $3.09 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $3.09 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.04 | $3.16 | $3.16 |
Where Indiana sits
The same service costs 2.9 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· 45th of 51
$18.62
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.