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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $17.78 Typical High $17.78 | Professional | None | $11.75 | $17.78 | $17.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $20.42 | Facility | None | $10.47 | $10.47 | $20.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $11.22 Typical High $21.38 | Professional | None | $10.47 | $11.22 | $21.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.05 Median $1.05 Typical High $1.48 | Professional | RR · Rental | $1.05 | $1.05 | $1.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.94 Median $7.94 Typical High $11.22 | Professional | UE · Used equipment | $7.94 | $7.94 | $11.22 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $31.62 | Facility | None | $30.20 | $30.20 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $14.79 | Facility | None | $13.80 | $13.80 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $104.71 | Professional | None | $8.71 | $11.75 | $104.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $64.57 Median $912.01 Typical High $2,187.76 | Facility | None | $64.57 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $12.59 Median $16.98 Typical High $26.30 | Professional | None | $12.59 | $16.98 | $26.30 |
United Setting Professional Modifier None Typical Low $5.89 Median $10.47 Typical High $17.38 | Professional | None | $5.89 | $10.47 | $17.38 |
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 $1.78 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $1.78 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.17 | $1.82 | $1.82 |
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
$11.22
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.