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 $0.81 Median $0.81 Typical High $0.81 | Facility | None | $0.81 | $0.81 | $0.81 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.81 Typical High $0.81 | Professional | None | $0.54 | $0.81 | $0.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.81 | Facility | None | $0.42 | $0.42 | $0.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.98 | Professional | None | $0.42 | $0.42 | $0.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.32 Median $0.41 Typical High $0.43 | Professional | UE · Used equipment | $0.32 | $0.41 | $0.43 |
CareSource Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.45 | Facility | None | $1.38 | $1.38 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $4.68 | Professional | None | $0.49 | $0.49 | $4.68 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2.95 Median $912.01 Typical High $2,187.76 | Facility | None | $2.95 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.59 Median $0.76 Typical High $1.51 | Professional | None | $0.59 | $0.76 | $1.51 |
United Setting Professional Modifier None Typical Low $0.27 Median $0.48 Typical High $0.79 | Professional | None | $0.27 | $0.48 | $0.79 |
5 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 $0.27 Median $0.41 Typical High $0.41 | Professional | 52 · Reduced service | $0.27 | $0.41 | $0.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.11 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.08 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.05 | $0.08 | $0.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | RR · Rental | $0.05 | $0.05 | $0.07 |
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· 48th of 51
$0.47
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.