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 $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $7.08 Typical High $7.08 | Professional | None | $4.68 | $7.08 | $7.08 |
Ambetter Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $7.08 | Facility | None | $3.63 | $3.63 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $8.32 | Professional | None | $3.63 | $3.63 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.37 Median $0.37 Typical High $0.48 | Professional | RR · Rental | $0.37 | $0.37 | $0.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.75 Median $2.75 Typical High $3.72 | Professional | UE · Used equipment | $2.75 | $2.75 | $3.72 |
CareSource Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.30 | Facility | None | $12.02 | $12.02 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $40.74 | Professional | None | $4.27 | $4.27 | $40.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $25.12 Median $912.01 Typical High $2,187.76 | Facility | None | $25.12 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $5.13 Median $6.61 Typical High $13.18 | Professional | None | $5.13 | $6.61 | $13.18 |
United Setting Professional Modifier None Typical Low $2.34 Median $4.07 Typical High $6.92 | Professional | None | $2.34 | $4.07 | $6.92 |
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 $2.29 Median $3.55 Typical High $3.55 | Professional | 52 · Reduced service | $2.29 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $1.41 Typical High $1.41 | Professional | 53 · Discontinued | $0.93 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $0.69 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.71 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.46 | $0.71 | $0.71 |
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· 48th of 51
$4.07
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.