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 $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.17 Median $0.28 Typical High $0.28 | Professional | None | $0.17 | $0.28 | $0.28 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $22.91 | Professional | None | $15.14 | $15.14 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.06 Median $0.06 Typical High $0.12 | Facility | None | $0.06 | $0.06 | $0.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.24 | Professional | None | $0.06 | $0.06 | $0.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | UE · Used equipment | $0.05 | $0.06 | $0.06 |
CareSource Setting Facility Modifier None Typical Low $0.15 Median $0.18 Typical High $0.21 | Facility | None | $0.15 | $0.18 | $0.21 |
CareSource Setting Professional Modifier None Typical Low $0.30 Median $0.35 Typical High $0.42 | Professional | None | $0.30 | $0.35 | $0.42 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $1.58 | Professional | None | $0.06 | $0.06 | $1.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.02 Median $0.30 Typical High $245.47 | Professional | None | $0.02 | $0.30 | $245.47 |
United Setting Professional Modifier None Typical Low $0.04 Median $0.07 Typical High $0.12 | Professional | None | $0.04 | $0.07 | $0.12 |
5 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 $0.03 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.03 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | AW · With surgical dressing | $0.04 | $0.04 | $0.04 |
Anthem BCBS Setting Professional Modifier AW · With surgical dressing Typical Low $0.14 Median $0.14 Typical High $0.21 | Professional | AW · With surgical dressing | $0.14 | $0.14 | $0.21 |
Cigna Setting Professional Modifier AW · With surgical dressing Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | AW · With surgical dressing | $0.16 | $0.16 | $0.16 |
Where Indiana sits
The same service costs 6.0 times more in Minnesota than in Wyoming. 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· 12th of 51
$0.12
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.