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 $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $7.24 Typical High $7.24 | Professional | None | $4.68 | $7.24 | $7.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $8.13 | Facility | None | $4.17 | $4.17 | $8.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.47 Typical High $8.51 | Professional | None | $4.17 | $4.47 | $8.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.42 Typical High $0.60 | Professional | RR · Rental | $0.42 | $0.42 | $0.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.16 Median $3.16 Typical High $4.68 | Professional | UE · Used equipment | $3.16 | $3.16 | $4.68 |
CareSource Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.59 | Facility | None | $12.02 | $12.02 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.37 | Facility | None | $5.01 | $5.01 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $41.69 | Professional | None | $4.27 | $5.01 | $41.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $25.12 Median $912.01 Typical High $2,187.76 | Facility | None | $25.12 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $5.25 Median $6.76 Typical High $12.02 | Professional | None | $5.25 | $6.76 | $12.02 |
United Setting Professional Modifier None Typical Low $2.34 Median $4.17 Typical High $6.92 | Professional | None | $2.34 | $4.17 | $6.92 |
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 $0.71 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $0.71 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.47 | $0.72 | $0.72 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | KX · Policy requirements met | $6.03 | $6.03 | $6.03 |
Where Indiana sits
The same service costs 2.1 times more in Hawaii 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· 40th of 51
$4.47
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.