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 $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $9.77 Typical High $9.77 | Professional | None | $6.46 | $9.77 | $9.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $10.96 | Facility | None | $5.75 | $5.75 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $11.75 | Professional | None | $5.75 | $6.03 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.56 Median $0.56 Typical High $0.81 | Professional | RR · Rental | $0.56 | $0.56 | $0.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.27 Median $4.27 Typical High $6.03 | Professional | UE · Used equipment | $4.27 | $4.27 | $6.03 |
CareSource Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.98 | Facility | None | $16.60 | $16.60 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.41 | Facility | None | $6.92 | $6.92 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $6.92 Typical High $56.23 | Professional | None | $5.89 | $6.92 | $56.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $35.48 Median $912.01 Typical High $2,187.76 | Facility | None | $35.48 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $14.45 | Professional | None | $6.92 | $9.12 | $14.45 |
United Setting Professional Modifier None Typical Low $3.24 Median $5.75 Typical High $9.55 | Professional | None | $3.24 | $5.75 | $9.55 |
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 $0.95 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $0.95 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.98 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.65 | $0.98 | $0.98 |
Where Indiana sits
The same service costs 2.1 times more in Idaho 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· 39th of 51
$6.03
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.