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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $4.27 Typical High $4.27 | Professional | None | $2.82 | $4.27 | $4.27 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $4.79 | Facility | None | $2.51 | $2.51 | $4.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.63 Typical High $5.13 | Professional | None | $2.51 | $2.63 | $5.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.25 Median $0.25 Typical High $0.35 | Professional | RR · Rental | $0.25 | $0.25 | $0.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.86 Median $1.86 Typical High $2.82 | Professional | UE · Used equipment | $1.86 | $1.86 | $2.82 |
CareSource Setting Facility Modifier None Typical Low $5.01 Median $7.24 Typical High $7.59 | Facility | None | $5.01 | $7.24 | $7.59 |
CareSource Setting Professional Modifier None Typical Low $5.01 Median $6.46 Typical High $7.08 | Professional | None | $5.01 | $6.46 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.24 | Facility | None | $3.02 | $3.02 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $3.02 Typical High $24.55 | Professional | None | $2.57 | $3.02 | $24.55 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $15.14 Median $912.01 Typical High $2,187.76 | Facility | None | $15.14 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3.09 Median $4.07 Typical High $7.24 | Professional | None | $3.09 | $4.07 | $7.24 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.51 Typical High $4.17 | Professional | None | $1.41 | $2.51 | $4.17 |
4 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 52 · Reduced service Typical Low $1.41 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $1.41 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.56 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.42 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.28 | $0.43 | $0.43 |
Where Indiana sits
The same service costs 2.3 times more in Kansas than in Connecticut. 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
$2.69
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.