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 $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.18 Median $0.28 Typical High $0.28 | Professional | None | $0.18 | $0.28 | $0.28 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.26 Median $0.26 Typical High $0.50 | Facility | None | $0.26 | $0.26 | $0.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.76 | Professional | None | $0.26 | $0.26 | $0.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | RR · Rental | $0.03 | $0.03 | $0.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.20 Median $0.26 Typical High $0.28 | Professional | UE · Used equipment | $0.20 | $0.26 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $7.41 | Professional | None | $0.28 | $0.28 | $7.41 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,290.87 | Facility | None | $912.01 | $2,089.30 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.07 Median $0.30 Typical High $245.47 | Professional | None | $0.07 | $0.30 | $245.47 |
United Setting Professional Modifier None Typical Low $0.14 Median $0.20 Typical High $0.34 | Professional | None | $0.14 | $0.20 | $0.34 |
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 $0.03 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.03 |
Where Indiana sits
The same service costs 15.5 times more in Minnesota than in Hawaii. 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· 19th of 51
$0.28
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.