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 $0.76 Median $0.76 Typical High $0.76 | Facility | None | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier None Typical Low $0.50 Median $0.76 Typical High $0.76 | Professional | None | $0.50 | $0.76 | $0.76 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.38 Median $0.38 Typical High $0.72 | Facility | None | $0.38 | $0.38 | $0.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.89 | Professional | None | $0.38 | $0.38 | $0.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.28 Median $0.38 Typical High $0.41 | Professional | UE · Used equipment | $0.28 | $0.38 | $0.41 |
CareSource Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.32 | Facility | None | $1.29 | $1.29 | $1.32 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $4.37 | Professional | None | $0.45 | $0.45 | $4.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2.69 Median $912.01 Typical High $2,187.76 | Facility | None | $2.69 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.54 Median $0.69 Typical High $1.41 | Professional | None | $0.54 | $0.69 | $1.41 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.44 Typical High $0.72 | Professional | None | $0.25 | $0.44 | $0.72 |
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 $0.25 Median $0.38 Typical High $0.38 | Professional | 52 · Reduced service | $0.25 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.15 Typical High $0.15 | Professional | 53 · Discontinued | $0.10 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.08 | $0.11 | $0.11 |
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 $0.06 Median $0.06 Typical High $0.08 | Professional | RR · Rental | $0.06 | $0.06 | $0.08 |
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· 49th of 51
$0.43
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.