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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $19.05 Typical High $19.05 | Professional | None | $10.72 | $19.05 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $19.50 | Facility | None | $10.00 | $10.00 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $22.91 | Professional | None | $10.00 | $10.00 | $22.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.00 Median $1.00 Typical High $1.51 | Professional | RR · Rental | $1.00 | $1.00 | $1.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.59 Median $7.59 Typical High $11.22 | Professional | UE · Used equipment | $7.59 | $7.59 | $11.22 |
CareSource Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.88 | Facility | None | $32.36 | $32.36 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $14.45 | Facility | None | $13.49 | $13.49 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $13.18 Typical High $107.15 | Professional | None | $11.48 | $13.18 | $107.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $69.18 Median $912.01 Typical High $2,187.76 | Facility | None | $69.18 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $13.49 Median $18.20 Typical High $28.18 | Professional | None | $13.49 | $18.20 | $28.18 |
United Setting Professional Modifier None Typical Low $6.31 Median $10.96 Typical High $18.62 | Professional | None | $6.31 | $10.96 | $18.62 |
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 $1.62 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $1.62 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.07 | $1.91 | $1.91 |
Where Indiana sits
The same service costs 2.8 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· 47th of 51
$11.22
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.