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 $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $8.32 Typical High $8.32 | Professional | None | $5.50 | $8.32 | $8.32 |
Ambetter Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | None | $12.88 | $12.88 | $15.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $8.13 | Facility | None | $4.17 | $4.17 | $8.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.80 Median $4.17 Typical High $10.00 | Professional | None | $3.80 | $4.17 | $10.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.38 Median $0.42 Typical High $0.63 | Professional | RR · Rental | $0.38 | $0.42 | $0.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.69 Median $3.16 Typical High $4.79 | Professional | UE · Used equipment | $2.69 | $3.16 | $4.79 |
CareSource Setting Facility Modifier None Typical Low $9.77 Median $14.13 Typical High $14.79 | Facility | None | $9.77 | $14.13 | $14.79 |
CareSource Setting Professional Modifier None Typical Low $9.77 Median $12.59 Typical High $13.80 | Professional | None | $9.77 | $12.59 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $6.31 | Facility | None | $5.89 | $5.89 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.89 Typical High $47.86 | Professional | None | $5.01 | $5.89 | $47.86 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $29.51 Median $912.01 Typical High $2,187.76 | Facility | None | $29.51 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $5.89 Median $7.94 Typical High $12.30 | Professional | None | $5.89 | $7.94 | $12.30 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.90 Typical High $8.13 | Professional | None | $2.75 | $4.90 | $8.13 |
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 $0.81 Median $1.26 Typical High $1.26 | Professional | 55 · Aftercare only | $0.81 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.83 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.55 | $0.83 | $0.83 |
Where Indiana sits
The same service costs 2.4 times more in Kansas 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· 45th of 51
$5.01
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.