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 $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $4.07 | Professional | None | $2.69 | $4.07 | $4.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $4.57 | Facility | None | $2.40 | $2.40 | $4.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.40 Median $2.51 Typical High $4.90 | Professional | None | $2.40 | $2.51 | $4.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.24 Median $0.24 Typical High $0.35 | Professional | RR · Rental | $0.24 | $0.24 | $0.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.78 Median $1.78 Typical High $2.51 | Professional | UE · Used equipment | $1.78 | $1.78 | $2.51 |
CareSource Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.08 | Facility | None | $6.92 | $6.92 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $3.09 | Facility | None | $2.88 | $2.88 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.88 Typical High $23.44 | Professional | None | $2.45 | $2.88 | $23.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $14.45 Median $912.01 Typical High $2,187.76 | Facility | None | $14.45 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.95 Median $3.89 Typical High $6.92 | Professional | None | $2.95 | $3.89 | $6.92 |
United Setting Professional Modifier None Typical Low $1.35 Median $2.40 Typical High $3.98 | Professional | None | $1.35 | $2.40 | $3.98 |
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 $0.40 Median $0.62 Typical High $0.62 | Professional | 55 · Aftercare only | $0.40 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.41 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.27 | $0.41 | $0.41 |
Where Indiana sits
The same service costs 2.8 times more in Kansas than in Delaware. 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
$2.51
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.