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 $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $9.77 Typical High $9.77 | Professional | None | $6.46 | $9.77 | $9.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $11.22 | Facility | None | $5.75 | $5.75 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $11.75 | Professional | None | $5.75 | $5.75 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.58 Median $0.58 Typical High $0.81 | Professional | RR · Rental | $0.58 | $0.58 | $0.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.37 Median $4.37 Typical High $6.17 | Professional | UE · Used equipment | $4.37 | $4.37 | $6.17 |
CareSource Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $17.38 | Facility | None | $16.60 | $16.60 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $8.13 | Facility | None | $7.59 | $7.59 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $56.23 | Professional | None | $6.46 | $7.59 | $56.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $35.48 Median $912.01 Typical High $2,187.76 | Facility | None | $35.48 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $7.24 Median $9.33 Typical High $16.60 | Professional | None | $7.24 | $9.33 | $16.60 |
United Setting Professional Modifier None Typical Low $3.24 Median $5.75 Typical High $9.55 | Professional | None | $3.24 | $5.75 | $9.55 |
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 $3.24 Median $4.90 Typical High $4.90 | Professional | 52 · Reduced service | $3.24 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.95 Typical High $1.95 | Professional | 53 · Discontinued | $1.29 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $0.98 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.65 | $1.00 | $1.00 |
Where Indiana sits
The same service costs 2.1 times more in Idaho 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· 46th of 51
$6.17
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.