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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $8.71 Typical High $8.71 | Professional | None | $5.50 | $8.71 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $9.33 | Facility | None | $4.79 | $4.79 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.79 Median $5.13 Typical High $10.47 | Professional | None | $4.79 | $5.13 | $10.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.48 Median $0.48 Typical High $0.71 | Professional | RR · Rental | $0.48 | $0.48 | $0.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.63 Median $3.63 Typical High $5.25 | Professional | UE · Used equipment | $3.63 | $3.63 | $5.25 |
CareSource Setting Facility Modifier None Typical Low $10.23 Median $14.79 Typical High $15.49 | Facility | None | $10.23 | $14.79 | $15.49 |
CareSource Setting Professional Modifier None Typical Low $10.23 Median $13.49 Typical High $14.45 | Professional | None | $10.23 | $13.49 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Facility | None | $6.17 | $6.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $6.17 Typical High $48.98 | Professional | None | $5.25 | $6.17 | $48.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $30.90 Median $912.01 Typical High $2,187.76 | Facility | None | $30.90 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $6.17 Median $8.32 Typical High $12.88 | Professional | None | $6.17 | $8.32 | $12.88 |
United Setting Professional Modifier None Typical Low $2.88 Median $4.90 Typical High $8.51 | Professional | None | $2.88 | $4.90 | $8.51 |
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 $0.83 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $0.83 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.56 | $0.87 | $0.87 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | KX · Policy requirements met | $6.76 | $6.76 | $6.76 |
Where Indiana sits
The same service costs 2.1 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· 46th of 51
$5.25
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.