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 $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $3.72 Typical High $3.72 | Professional | None | $2.51 | $3.72 | $3.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $4.07 | Facility | None | $2.14 | $2.14 | $4.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.24 Typical High $4.47 | Professional | None | $2.14 | $2.24 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.21 Median $0.21 Typical High $0.30 | Professional | RR · Rental | $0.21 | $0.21 | $0.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.58 Median $1.58 Typical High $2.29 | Professional | UE · Used equipment | $1.58 | $1.58 | $2.29 |
CareSource Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $6.61 | Facility | None | $6.46 | $6.46 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $2.88 | Facility | None | $2.69 | $2.69 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.69 Typical High $21.38 | Professional | None | $2.29 | $2.69 | $21.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $13.18 Median $912.01 Typical High $2,187.76 | Facility | None | $13.18 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.69 Median $3.55 Typical High $6.31 | Professional | None | $2.69 | $3.55 | $6.31 |
United Setting Professional Modifier None Typical Low $1.26 Median $2.19 Typical High $3.63 | Professional | None | $1.26 | $2.19 | $3.63 |
2 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 $0.38 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.38 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.25 | $0.37 | $0.37 |
Where Indiana sits
The same service costs 2.3 times more in Hawaii 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· 47th of 51
$2.29
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.