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 $2.00 Median $2.00 Typical High $3.47 | Facility | None | $2.00 | $2.00 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $2.00 Typical High $2.00 | Professional | None | $1.26 | $2.00 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $2.29 | Facility | None | $1.17 | $1.17 | $2.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.26 Typical High $2.34 | Professional | None | $1.17 | $1.26 | $2.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.12 Median $0.12 Typical High $0.17 | Professional | RR · Rental | $0.12 | $0.12 | $0.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.89 Median $0.95 Typical High $1.32 | Professional | UE · Used equipment | $0.89 | $0.95 | $1.32 |
CareSource Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.09 | Facility | None | $3.02 | $3.02 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.51 | Facility | None | $1.41 | $1.41 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.41 Typical High $11.22 | Professional | None | $1.20 | $1.41 | $11.22 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $7.08 Median $912.01 Typical High $2,187.76 | Facility | None | $7.08 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1.41 Median $1.86 Typical High $2.95 | Professional | None | $1.41 | $1.86 | $2.95 |
United Setting Professional Modifier None Typical Low $0.66 Median $1.15 Typical High $1.95 | Professional | None | $0.66 | $1.15 | $1.95 |
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 $0.19 Median $0.30 Typical High $0.30 | Professional | 55 · Aftercare only | $0.19 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.13 | $0.20 | $0.20 |
Where Indiana sits
The same service costs 5.4 times more in Kansas than in Kentucky. 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· 38th of 51
$1.26
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.