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 $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $3.31 Typical High $3.31 | Professional | None | $2.19 | $3.31 | $3.31 |
Ambetter Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $3.80 | Facility | None | $1.95 | $1.95 | $3.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $2.04 Typical High $3.98 | Professional | None | $1.95 | $2.04 | $3.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.20 Median $0.20 Typical High $0.28 | Professional | RR · Rental | $0.20 | $0.20 | $0.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.45 Median $1.45 Typical High $2.19 | Professional | UE · Used equipment | $1.45 | $1.45 | $2.19 |
CareSource Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.89 | Facility | None | $5.62 | $5.62 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.34 Typical High $19.50 | Professional | None | $2.00 | $2.34 | $19.50 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $11.75 Median $912.01 Typical High $2,187.76 | Facility | None | $11.75 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.40 Median $3.16 Typical High $5.62 | Professional | None | $2.40 | $3.16 | $5.62 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.95 Typical High $3.24 | Professional | None | $1.10 | $1.95 | $3.24 |
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 $1.10 Median $1.66 Typical High $1.66 | Professional | 52 · Reduced service | $1.10 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.44 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.33 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.22 | $0.33 | $0.33 |
Where Indiana sits
The same service costs 2.2 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· 46th of 51
$2.04
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.