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 $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $13.49 Typical High $13.49 | Professional | None | $8.91 | $13.49 | $13.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $15.14 | Facility | None | $7.94 | $7.94 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.94 Median $8.13 Typical High $16.22 | Professional | None | $7.94 | $8.13 | $16.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.79 Median $0.79 Typical High $1.12 | Professional | RR · Rental | $0.79 | $0.79 | $1.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.89 Median $5.89 Typical High $8.91 | Professional | UE · Used equipment | $5.89 | $5.89 | $8.91 |
CareSource Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $23.44 | Facility | None | $22.91 | $22.91 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $10.23 | Facility | None | $9.55 | $9.55 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $9.55 Typical High $77.62 | Professional | None | $8.13 | $9.55 | $77.62 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $48.98 Median $912.01 Typical High $2,187.76 | Facility | None | $48.98 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $9.55 Median $12.59 Typical High $19.95 | Professional | None | $9.55 | $12.59 | $19.95 |
United Setting Professional Modifier None Typical Low $4.47 Median $7.94 Typical High $13.18 | Professional | None | $4.47 | $7.94 | $13.18 |
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 $1.32 Median $2.04 Typical High $2.04 | Professional | 55 · Aftercare only | $1.32 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.35 Typical High $1.35 | Professional | 56 · Pre-op care only | $0.89 | $1.35 | $1.35 |
Where Indiana sits
The same service costs 2.2 times more in Kansas 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· 44th of 51
$8.13
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.