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 $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $10.47 Typical High $10.47 | Professional | None | $6.92 | $10.47 | $10.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $11.75 | Facility | None | $6.17 | $6.17 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $6.46 Typical High $12.59 | Professional | None | $6.17 | $6.46 | $12.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.62 Median $0.62 Typical High $0.87 | Professional | RR · Rental | $0.62 | $0.62 | $0.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.57 Median $4.57 Typical High $6.46 | Professional | UE · Used equipment | $4.57 | $4.57 | $6.46 |
CareSource Setting Facility Modifier None Typical Low $12.30 Median $17.78 Typical High $18.20 | Facility | None | $12.30 | $17.78 | $18.20 |
CareSource Setting Professional Modifier None Typical Low $12.30 Median $15.85 Typical High $16.98 | Professional | None | $12.30 | $15.85 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.94 | Facility | None | $7.41 | $7.41 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $7.41 Typical High $60.26 | Professional | None | $6.31 | $7.41 | $60.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $37.15 Median $912.01 Typical High $2,187.76 | Facility | None | $37.15 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $7.59 Median $10.00 Typical High $17.78 | Professional | None | $7.59 | $10.00 | $17.78 |
United Setting Professional Modifier None Typical Low $3.47 Median $6.17 Typical High $10.23 | Professional | None | $3.47 | $6.17 | $10.23 |
3 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 $1.02 Median $1.58 Typical High $1.58 | Professional | 55 · Aftercare only | $1.02 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.69 | $1.05 | $1.05 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | KX · Policy requirements met | $8.71 | $8.71 | $8.71 |
Where Indiana sits
The same service costs 2.0 times more in Montana than in Florida. 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· 40th of 51
$6.46
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.