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 $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $11.48 Typical High $11.48 | Professional | None | $7.59 | $11.48 | $11.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $12.88 | Facility | None | $6.76 | $6.76 | $12.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $7.08 Typical High $13.80 | Professional | None | $6.76 | $7.08 | $13.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.68 Median $0.68 Typical High $0.95 | Professional | RR · Rental | $0.68 | $0.68 | $0.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.01 Median $5.01 Typical High $7.41 | Professional | UE · Used equipment | $5.01 | $5.01 | $7.41 |
CareSource Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.95 | Facility | None | $19.50 | $19.50 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.71 | Facility | None | $8.13 | $8.13 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $8.13 Typical High $66.07 | Professional | None | $6.92 | $8.13 | $66.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $40.74 Median $912.01 Typical High $2,187.76 | Facility | None | $40.74 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $8.13 Median $10.72 Typical High $16.98 | Professional | None | $8.13 | $10.72 | $16.98 |
United Setting Professional Modifier None Typical Low $3.80 Median $6.76 Typical High $11.22 | Professional | None | $3.80 | $6.76 | $11.22 |
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 $1.12 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.12 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $0.76 | $1.15 | $1.15 |
Where Indiana sits
The same service costs 2.1 times more in Hawaii than in Colorado. 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· 41st of 51
$7.08
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.