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 $2.09 Median $2.09 Typical High $2.45 | Facility | None | $2.09 | $2.09 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $2.09 Typical High $2.09 | Professional | None | $1.35 | $2.09 | $2.09 |
Ambetter Setting Professional Modifier None Typical Low $1.48 Median $2.95 Typical High $3.72 | Professional | None | $1.48 | $2.95 | $3.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $2.09 | Facility | None | $1.10 | $1.10 | $2.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $2.51 | Professional | None | $1.10 | $1.10 | $2.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.11 Median $0.11 Typical High $0.14 | Professional | RR · Rental | $0.11 | $0.11 | $0.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.81 Median $0.81 Typical High $1.26 | Professional | UE · Used equipment | $0.81 | $0.81 | $1.26 |
CareSource Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Facility | None | $3.55 | $3.55 | $3.72 |
CareSource Setting Professional Modifier None Typical Low $2.45 Median $2.95 Typical High $3.47 | Professional | None | $2.45 | $2.95 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $12.02 | Professional | None | $1.26 | $1.26 | $12.02 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $7.59 Median $912.01 Typical High $2,187.76 | Facility | None | $7.59 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1.51 Median $1.95 Typical High $3.89 | Professional | None | $1.51 | $1.95 | $3.89 |
United Setting Professional Modifier None Typical Low $0.69 Median $1.23 Typical High $2.04 | Professional | None | $0.69 | $1.23 | $2.04 |
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 $0.69 Median $1.05 Typical High $1.05 | Professional | 52 · Reduced service | $0.69 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.42 Typical High $0.42 | Professional | 53 · Discontinued | $0.27 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.32 Typical High $0.32 | Professional | 55 · Aftercare only | $0.21 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.14 | $0.21 | $0.21 |
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· 47th of 51
$1.23
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.