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 $1.66 Median $1.66 Typical High $1.66 | Facility | None | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.66 Typical High $1.66 | Professional | None | $1.10 | $1.66 | $1.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $1.66 | Facility | None | $0.85 | $0.85 | $1.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $2.00 | Professional | None | $0.85 | $0.85 | $2.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.09 Median $0.09 Typical High $0.11 | Professional | RR · Rental | $0.09 | $0.09 | $0.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.65 Median $0.79 Typical High $0.85 | Professional | UE · Used equipment | $0.65 | $0.79 | $0.85 |
CareSource Setting Facility Modifier None Typical Low $2.82 Median $2.82 Typical High $2.95 | Facility | None | $2.82 | $2.82 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $9.55 | Professional | None | $1.00 | $1.00 | $9.55 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $6.03 Median $912.01 Typical High $2,187.76 | Facility | None | $6.03 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1.20 Median $1.55 Typical High $3.09 | Professional | None | $1.20 | $1.55 | $3.09 |
United Setting Professional Modifier None Typical Low $0.55 Median $0.98 Typical High $1.62 | Professional | None | $0.55 | $0.98 | $1.62 |
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 $0.55 Median $0.83 Typical High $0.83 | Professional | 52 · Reduced service | $0.55 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.33 Typical High $0.33 | Professional | 53 · Discontinued | $0.22 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.16 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.11 | $0.17 | $0.17 |
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
$0.98
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.