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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $54.95 Typical High $54.95 | Professional | None | $35.48 | $54.95 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $52.48 | Facility | None | $26.92 | $26.92 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $64.57 | Professional | None | $26.92 | $26.92 | $64.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $4.07 | Professional | RR · Rental | $2.69 | $2.69 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $30.20 | Professional | UE · Used equipment | $20.42 | $20.42 | $30.20 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $95.50 | Facility | None | $93.33 | $93.33 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $40.74 | Facility | None | $38.02 | $38.02 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $295.12 | Professional | None | $32.36 | $35.48 | $295.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $194.98 Median $912.01 Typical High $2,187.76 | Facility | None | $194.98 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $79.43 | Professional | None | $38.90 | $51.29 | $79.43 |
United Setting Professional Modifier None Typical Low $18.20 Median $31.62 Typical High $52.48 | Professional | None | $18.20 | $31.62 | $52.48 |
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 $5.37 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $5.37 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.55 | $5.50 | $5.50 |
Where Indiana sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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
$31.62
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.