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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $20.42 Typical High $20.42 | Professional | None | $13.49 | $20.42 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $23.44 | Facility | None | $12.02 | $12.02 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $24.55 | Professional | None | $12.02 | $12.02 | $24.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.20 Median $1.20 Typical High $1.70 | Professional | RR · Rental | $1.20 | $1.20 | $1.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.12 Median $9.12 Typical High $12.88 | Professional | UE · Used equipment | $9.12 | $9.12 | $12.88 |
CareSource Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $36.31 | Facility | None | $34.67 | $34.67 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $16.98 | Facility | None | $15.85 | $15.85 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $117.49 | Professional | None | $10.00 | $13.49 | $117.49 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $74.13 Median $912.01 Typical High $2,187.76 | Facility | None | $74.13 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $14.45 Median $19.50 Typical High $30.20 | Professional | None | $14.45 | $19.50 | $30.20 |
United Setting Professional Modifier None Typical Low $6.76 Median $12.02 Typical High $19.95 | Professional | None | $6.76 | $12.02 | $19.95 |
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 $2.04 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.04 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.35 | $2.04 | $2.04 |
Where Indiana sits
The same service costs 2.3 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· 45th of 51
$12.88
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.