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 $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $5.01 Typical High $5.01 | Professional | None | $3.31 | $5.01 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $5.62 | Facility | None | $2.95 | $2.95 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $6.03 | Professional | None | $2.95 | $2.95 | $6.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.28 Median $0.28 Typical High $0.42 | Professional | RR · Rental | $0.28 | $0.28 | $0.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.19 Median $2.19 Typical High $3.16 | Professional | UE · Used equipment | $2.19 | $2.19 | $3.16 |
CareSource Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.71 | Facility | None | $8.51 | $8.51 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $4.07 | Facility | None | $3.80 | $3.80 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $28.84 | Professional | None | $2.45 | $3.24 | $28.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $18.20 Median $912.01 Typical High $2,187.76 | Facility | None | $18.20 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3.55 Median $4.68 Typical High $7.41 | Professional | None | $3.55 | $4.68 | $7.41 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.95 Typical High $4.90 | Professional | None | $1.66 | $2.95 | $4.90 |
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 $0.49 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.49 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.50 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.33 | $0.50 | $0.50 |
Where Indiana sits
The same service costs 3.2 times more in Kansas 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· 47th of 51
$3.09
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.