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 $0.47 Median $0.47 Typical High $0.47 | Facility | None | $0.47 | $0.47 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.31 Median $0.47 Typical High $0.47 | Professional | None | $0.31 | $0.47 | $0.47 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $40.74 | Professional | None | $38.90 | $38.90 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.25 Median $0.25 Typical High $0.48 | Facility | None | $0.25 | $0.25 | $0.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.18 Median $0.35 Typical High $0.55 | Professional | None | $0.18 | $0.35 | $0.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.19 Median $0.25 Typical High $0.27 | Professional | UE · Used equipment | $0.19 | $0.25 | $0.27 |
CareSource Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $0.81 | Facility | None | $0.78 | $0.78 | $0.81 |
CareSource Setting Professional Modifier None Typical Low $0.54 Median $0.65 Typical High $0.76 | Professional | None | $0.54 | $0.65 | $0.76 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $2.63 | Professional | None | $0.28 | $0.28 | $2.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1.66 Median $912.01 Typical High $2,187.76 | Facility | None | $1.66 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.33 Median $0.44 Typical High $0.85 | Professional | None | $0.33 | $0.44 | $0.85 |
United Setting Professional Modifier None Typical Low $0.16 Median $0.28 Typical High $0.46 | Professional | None | $0.16 | $0.28 | $0.46 |
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 $0.16 Median $0.24 Typical High $0.24 | Professional | 52 · Reduced service | $0.16 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.06 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.05 | $0.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.04 Typical High $0.06 | Professional | RR · Rental | $0.04 | $0.04 | $0.06 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 27th of 51
$0.33
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.