How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $6.03 Typical High $6.03 | Professional | None | $3.80 | $6.03 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.07 Median $5.13 Typical High $5.50 | Facility | None | $4.07 | $5.13 | $5.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $7.76 | Professional | None | $4.37 | $4.37 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.44 Median $0.44 Typical High $0.59 | Professional | RR · Rental | $0.44 | $0.44 | $0.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.31 Median $3.31 Typical High $5.13 | Professional | UE · Used equipment | $3.31 | $3.31 | $5.13 |
CareSource Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $5.75 Typical High $5.75 | Professional | None | $2.57 | $5.75 | $5.75 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $4.68 Median $954.99 Typical High $2,187.76 | Facility | None | $4.68 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1.05 Median $4.79 Typical High $5.75 | Professional | None | $1.05 | $4.79 | $5.75 |
United Setting Professional Modifier None Typical Low $2.09 Median $6.61 Typical High $10.47 | Professional | None | $2.09 | $6.61 | $10.47 |
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 $0.56 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.56 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.38 | $0.62 | $0.62 |
Where Indiana sits
The same service costs 4.2 times more in Kansas than in Delaware. 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· 45th of 51
$4.37
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.