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 $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $3.39 Typical High $3.39 | Professional | None | $2.57 | $3.39 | $3.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $4.47 | Facility | None | $2.29 | $2.29 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.29 Median $2.45 Typical High $3.98 | Professional | None | $2.29 | $2.45 | $3.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $0.23 Typical High $0.32 | Professional | RR · Rental | $0.23 | $0.23 | $0.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.74 Median $1.74 Typical High $2.57 | Professional | UE · Used equipment | $1.74 | $1.74 | $2.57 |
CareSource Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $6.61 | Facility | None | $6.31 | $6.31 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.82 | Facility | None | $2.57 | $2.57 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $21.38 | Professional | None | $1.91 | $2.19 | $21.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $12.02 Median $912.01 Typical High $2,187.76 | Facility | None | $12.02 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.34 Median $3.16 Typical High $4.90 | Professional | None | $2.34 | $3.16 | $4.90 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.95 Typical High $3.24 | Professional | None | $1.32 | $1.95 | $3.24 |
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 $0.39 Median $0.51 Typical High $0.51 | Professional | 55 · Aftercare only | $0.39 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.26 | $0.34 | $0.34 |
Where Indiana sits
The same service costs 2.5 times more in Hawaii than in Vermont. 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· 32nd of 51
$2.45
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.