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 $0.54 Median $0.54 Typical High $0.54 | Facility | None | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.54 Typical High $0.54 | Professional | None | $0.34 | $0.54 | $0.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.36 Median $0.46 Typical High $0.49 | Facility | None | $0.36 | $0.46 | $0.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.40 Median $0.44 Typical High $0.74 | Professional | None | $0.40 | $0.44 | $0.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.30 Median $0.40 Typical High $0.44 | Professional | UE · Used equipment | $0.30 | $0.40 | $0.44 |
CareSource Setting Facility Modifier None Typical Low $0.28 Median $0.30 Typical High $0.50 | Facility | None | $0.28 | $0.30 | $0.50 |
Cigna Setting Facility Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Facility | None | $2.00 | $2.00 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $0.33 Median $0.52 Typical High $0.52 | Professional | None | $0.33 | $0.52 | $0.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $0.72 Median $912.01 Typical High $2,137.96 | Facility | None | $0.72 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.09 Median $0.43 Typical High $0.52 | Professional | None | $0.09 | $0.43 | $0.52 |
United Setting Professional Modifier None Typical Low $0.19 Median $0.56 Typical High $0.89 | Professional | None | $0.19 | $0.56 | $0.89 |
3 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 $0.05 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.05 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.05 | $0.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.06 Typical High $0.08 | Professional | RR · Rental | $0.05 | $0.06 | $0.08 |
Where Indiana sits
The same service costs 3.0 times more in Florida 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· 37th of 51
$0.46
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.