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 $0.52 Median $0.56 Typical High $3.02 | Facility | None | $0.52 | $0.56 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.56 Typical High $0.56 | Professional | None | $0.36 | $0.56 | $0.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.34 Median $0.34 Typical High $0.66 | Facility | None | $0.34 | $0.34 | $0.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.10 Median $0.34 Typical High $0.45 | Professional | None | $0.10 | $0.34 | $0.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.26 Median $0.34 Typical High $0.36 | Professional | UE · Used equipment | $0.26 | $0.34 | $0.36 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $3.24 | Professional | None | $1.12 | $1.12 | $3.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,290.87 | Facility | None | $912.01 | $2,089.30 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.14 Median $0.62 Typical High $245.47 | Professional | None | $0.14 | $0.62 | $245.47 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.40 Typical High $0.69 | Professional | None | $0.28 | $0.40 | $0.69 |
3 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 $0.05 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.05 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.04 | $0.06 | $0.06 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | RR · Rental | $0.04 | $0.04 | $0.04 |
Where Indiana sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 50th of 51
$0.40
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.