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 $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $2.45 Typical High $2.45 | Professional | None | $1.62 | $2.45 | $2.45 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.34 | Professional | None | $2.04 | $2.04 | $2.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $3.55 | Facility | None | $1.82 | $1.82 | $3.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $2.95 | Professional | None | $1.82 | $1.82 | $2.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.18 Median $0.18 Typical High $0.25 | Professional | RR · Rental | $0.18 | $0.18 | $0.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.38 Median $1.38 Typical High $2.04 | Professional | UE · Used equipment | $1.38 | $1.38 | $2.04 |
CareSource Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.37 | Facility | None | $4.17 | $4.17 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.86 | Facility | None | $1.74 | $1.74 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.74 Typical High $14.13 | Professional | None | $1.48 | $1.74 | $14.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $8.91 Median $912.01 Typical High $2,187.76 | Facility | None | $8.91 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1.78 Median $2.40 Typical High $4.17 | Professional | None | $1.78 | $2.40 | $4.17 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.45 Typical High $2.40 | Professional | None | $0.81 | $1.45 | $2.40 |
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 $0.81 Median $1.23 Typical High $1.23 | Professional | 52 · Reduced service | $0.81 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.49 Typical High $0.49 | Professional | 53 · Discontinued | $0.32 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.37 Typical High $0.37 | Professional | 55 · Aftercare only | $0.24 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.16 | $0.25 | $0.25 |
Where Indiana sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 32nd of 51
$1.82
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.