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 $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $4.37 Typical High $4.37 | Professional | None | $2.88 | $4.37 | $4.37 |
Ambetter Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $4.90 | Facility | None | $2.57 | $2.57 | $4.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $2.69 Typical High $5.25 | Professional | None | $2.57 | $2.69 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.26 Typical High $0.38 | Professional | RR · Rental | $0.26 | $0.26 | $0.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.91 Median $1.91 Typical High $2.95 | Professional | UE · Used equipment | $1.91 | $1.91 | $2.95 |
CareSource Setting Facility Modifier None Typical Low $5.13 Median $7.41 Typical High $7.59 | Facility | None | $5.13 | $7.41 | $7.59 |
CareSource Setting Professional Modifier None Typical Low $5.13 Median $6.61 Typical High $7.08 | Professional | None | $5.13 | $6.61 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $3.31 | Facility | None | $3.09 | $3.09 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $3.09 Typical High $25.12 | Professional | None | $2.57 | $3.09 | $25.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $15.49 Median $912.01 Typical High $2,187.76 | Facility | None | $15.49 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3.09 Median $4.07 Typical High $6.46 | Professional | None | $3.09 | $4.07 | $6.46 |
United Setting Professional Modifier None Typical Low $1.45 Median $2.51 Typical High $4.27 | Professional | None | $1.45 | $2.51 | $4.27 |
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 $0.43 Median $0.66 Typical High $0.66 | Professional | 55 · Aftercare only | $0.43 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.44 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.28 | $0.44 | $0.44 |
Where Indiana sits
The same service costs 3.2 times more in Kansas than in Missouri. 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· 42nd of 51
$2.69
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.