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 $2.24 Median $2.24 Typical High $2.24 | Facility | None | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $2.24 Typical High $2.24 | Professional | None | $1.48 | $2.24 | $2.24 |
Ambetter Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $2.24 | Facility | None | $1.17 | $1.17 | $2.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $2.63 | Professional | None | $1.17 | $1.17 | $2.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.12 Median $0.12 Typical High $0.15 | Professional | RR · Rental | $0.12 | $0.12 | $0.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.87 Median $0.87 Typical High $1.32 | Professional | UE · Used equipment | $0.87 | $0.87 | $1.32 |
CareSource Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.89 | Facility | None | $3.80 | $3.80 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $12.88 | Professional | None | $1.32 | $1.32 | $12.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $7.94 Median $912.01 Typical High $2,187.76 | Facility | None | $7.94 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1.62 Median $2.09 Typical High $4.17 | Professional | None | $1.62 | $2.09 | $4.17 |
United Setting Professional Modifier None Typical Low $0.74 Median $1.32 Typical High $2.19 | Professional | None | $0.74 | $1.32 | $2.19 |
4 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 52 · Reduced service Typical Low $0.74 Median $1.12 Typical High $1.12 | Professional | 52 · Reduced service | $0.74 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.45 Typical High $0.45 | Professional | 53 · Discontinued | $0.28 | $0.45 | $0.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.34 Typical High $0.34 | Professional | 55 · Aftercare only | $0.22 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.15 | $0.22 | $0.22 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 45th of 51
$1.32
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.