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 $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $10.23 Typical High $10.23 | Professional | None | $6.61 | $10.23 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $11.48 | Facility | None | $6.03 | $6.03 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.03 Median $6.31 Typical High $12.02 | Professional | None | $6.03 | $6.31 | $12.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.60 Median $0.60 Typical High $0.85 | Professional | RR · Rental | $0.60 | $0.60 | $0.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.47 Median $4.47 Typical High $6.76 | Professional | UE · Used equipment | $4.47 | $4.47 | $6.76 |
CareSource Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.78 | Facility | None | $17.38 | $17.38 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $7.08 Typical High $58.88 | Professional | None | $6.03 | $7.08 | $58.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $36.31 Median $912.01 Typical High $2,187.76 | Facility | None | $36.31 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $17.38 | Professional | None | $7.41 | $9.77 | $17.38 |
United Setting Professional Modifier None Typical Low $3.39 Median $5.89 Typical High $10.00 | Professional | None | $3.39 | $5.89 | $10.00 |
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 $3.31 Median $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $3.31 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $1.35 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.00 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $1.02 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.68 | $1.02 | $1.02 |
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· 44th of 51
$6.31
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.