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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $12.02 Typical High $12.02 | Professional | None | $8.51 | $12.02 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $13.80 | Facility | None | $7.08 | $7.08 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.08 Median $7.59 Typical High $14.45 | Professional | None | $7.08 | $7.59 | $14.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.71 Median $0.71 Typical High $1.07 | Professional | RR · Rental | $0.71 | $0.71 | $1.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.37 Median $5.37 Typical High $8.32 | Professional | UE · Used equipment | $5.37 | $5.37 | $8.32 |
CareSource Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $21.38 | Facility | None | $20.42 | $20.42 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.72 | Facility | None | $10.00 | $10.00 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $75.86 | Professional | None | $8.51 | $9.33 | $75.86 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $43.65 Median $912.01 Typical High $2,187.76 | Facility | None | $43.65 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $8.51 Median $11.48 Typical High $17.78 | Professional | None | $8.51 | $11.48 | $17.78 |
United Setting Professional Modifier None Typical Low $4.68 Median $7.08 Typical High $11.75 | Professional | None | $4.68 | $7.08 | $11.75 |
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 $1.26 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.26 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.85 | $1.20 | $1.20 |
Where Indiana sits
The same service costs 2.3 times more in Montana 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
$8.32
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.