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 $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $5.89 Typical High $5.89 | Professional | None | $3.89 | $5.89 | $5.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $6.03 | Facility | None | $3.09 | $3.09 | $6.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $7.08 | Professional | None | $3.09 | $3.09 | $7.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.31 Median $0.31 Typical High $0.46 | Professional | RR · Rental | $0.31 | $0.31 | $0.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.34 Median $2.34 Typical High $3.47 | Professional | UE · Used equipment | $2.34 | $2.34 | $3.47 |
CareSource Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.23 | Facility | None | $10.00 | $10.00 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.47 | Facility | None | $4.17 | $4.17 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $4.07 Typical High $33.11 | Professional | None | $3.55 | $4.07 | $33.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $21.38 Median $912.01 Typical High $2,187.76 | Facility | None | $21.38 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $4.17 Median $5.50 Typical High $8.71 | Professional | None | $4.17 | $5.50 | $8.71 |
United Setting Professional Modifier None Typical Low $1.95 Median $3.47 Typical High $5.75 | Professional | None | $1.95 | $3.47 | $5.75 |
3 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 $0.58 Median $0.87 Typical High $0.87 | Professional | 55 · Aftercare only | $0.58 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.59 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.39 | $0.59 | $0.59 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | KX · Policy requirements met | $4.90 | $4.90 | $4.90 |
Where Indiana sits
The same service costs 2.1 times more in Idaho 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· 46th of 51
$3.55
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.