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 $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $6.92 Typical High $6.92 | Professional | None | $4.47 | $6.92 | $6.92 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $7.76 | Facility | None | $3.98 | $3.98 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.98 Median $4.27 Typical High $8.13 | Professional | None | $3.98 | $4.27 | $8.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.40 Median $0.40 Typical High $0.58 | Professional | RR · Rental | $0.40 | $0.40 | $0.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.02 Typical High $4.47 | Professional | UE · Used equipment | $3.02 | $3.02 | $4.47 |
CareSource Setting Facility Modifier None Typical Low $7.94 Median $11.48 Typical High $12.02 | Facility | None | $7.94 | $11.48 | $12.02 |
CareSource Setting Professional Modifier None Typical Low $7.94 Median $10.47 Typical High $11.22 | Professional | None | $7.94 | $10.47 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.79 Typical High $39.81 | Professional | None | $4.07 | $4.79 | $39.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $23.99 Median $912.01 Typical High $2,187.76 | Facility | None | $23.99 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $5.01 Median $6.46 Typical High $11.48 | Professional | None | $5.01 | $6.46 | $11.48 |
United Setting Professional Modifier None Typical Low $2.24 Median $3.98 Typical High $6.61 | Professional | None | $2.24 | $3.98 | $6.61 |
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 $0.68 Median $1.02 Typical High $1.02 | Professional | 55 · Aftercare only | $0.68 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.69 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.45 | $0.69 | $0.69 |
Where Indiana sits
The same service costs 2.3 times more in Kansas than in Utah. 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
$4.27
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.