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 $0.12 Median $0.12 Typical High $0.12 | Facility | None | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | None | $0.12 | $0.12 | $0.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $57.54 | Facility | None | $30.20 | $30.20 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $39.81 | Professional | None | $30.20 | $30.20 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.02 Median $3.02 Typical High $3.98 | Professional | RR · Rental | $3.02 | $3.02 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.39 Median $22.39 Typical High $29.51 | Professional | UE · Used equipment | $22.39 | $22.39 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $0.06 Median $0.06 Typical High $0.06 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.40 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.02 | $0.40 | $1.70 |
Where Indiana sits
The same service costs 660.7 times more in Montana than in Louisiana. 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· 4th of 51
$30.20
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.