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 $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $190.55 | Facility | None | $97.72 | $97.72 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $97.72 Typical High $112.20 | Professional | None | $45.71 | $97.72 | $112.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.77 Median $9.77 Typical High $12.88 | Professional | RR · Rental | $9.77 | $9.77 | $12.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | UE · Used equipment | $74.13 | $74.13 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,290.87 | Facility | None | $912.01 | $2,089.30 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $60.26 | Professional | None | $34.67 | $39.81 | $60.26 |
2 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 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Where Indiana sits
The same service costs 512.9 times more in North Carolina than in South Carolina. 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· 7th of 51
$97.72
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.