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 $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $6.46 Typical High $6.46 | Professional | None | $4.17 | $6.46 | $6.46 |
Ambetter Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $6.61 | Facility | None | $3.47 | $3.47 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $7.76 | Professional | None | $3.47 | $3.47 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.51 | Professional | RR · Rental | $0.34 | $0.34 | $0.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $3.89 | Professional | UE · Used equipment | $2.57 | $2.57 | $3.89 |
CareSource Setting Facility Modifier None Typical Low $7.59 Median $10.96 Typical High $11.48 | Facility | None | $7.59 | $10.96 | $11.48 |
CareSource Setting Professional Modifier None Typical Low $7.59 Median $10.00 Typical High $10.72 | Professional | None | $7.59 | $10.00 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.75 | Facility | None | $5.37 | $5.37 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $5.37 Typical High $42.66 | Professional | None | $4.57 | $5.37 | $42.66 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $23.44 Median $912.01 Typical High $2,187.76 | Facility | None | $23.44 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $4.57 Median $6.17 Typical High $9.55 | Professional | None | $4.57 | $6.17 | $9.55 |
United Setting Professional Modifier None Typical Low $2.51 Median $3.80 Typical High $6.31 | Professional | None | $2.51 | $3.80 | $6.31 |
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 $0.65 Median $0.98 Typical High $0.98 | Professional | 55 · Aftercare only | $0.65 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.65 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.43 | $0.65 | $0.65 |
Where Indiana sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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· 49th of 51
$4.17
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.