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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $51.29 | Professional | None | $34.67 | $51.29 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $56.23 | Facility | None | $28.84 | $28.84 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $61.66 | Professional | None | $28.84 | $30.90 | $61.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.88 Median $2.88 Typical High $4.37 | Professional | RR · Rental | $2.88 | $2.88 | $4.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $21.88 Median $21.88 Typical High $33.88 | Professional | UE · Used equipment | $21.88 | $21.88 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $97.72 | Facility | None | $95.50 | $95.50 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $43.65 | Facility | None | $40.74 | $40.74 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $323.59 | Professional | None | $34.67 | $38.02 | $323.59 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $186.21 Median $912.01 Typical High $2,187.76 | Facility | None | $186.21 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $36.31 Median $48.98 Typical High $75.86 | Professional | None | $36.31 | $48.98 | $75.86 |
United Setting Professional Modifier None Typical Low $19.50 Median $30.20 Typical High $50.12 | Professional | None | $19.50 | $30.20 | $50.12 |
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 $5.25 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $5.25 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.47 | $5.13 | $5.13 |
Where Indiana sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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
$32.36
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.