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 $0.44 Median $0.44 Typical High $0.44 | Facility | None | $0.44 | $0.44 | $0.44 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.44 Typical High $0.44 | Professional | None | $0.28 | $0.44 | $0.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.31 Median $0.39 Typical High $0.49 | Facility | None | $0.31 | $0.39 | $0.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.37 Median $0.44 Typical High $0.72 | Professional | None | $0.37 | $0.44 | $0.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.25 Median $0.33 Typical High $0.37 | Professional | UE · Used equipment | $0.25 | $0.33 | $0.37 |
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 $0.24 Median $0.44 Typical High $2.82 | Professional | None | $0.24 | $0.44 | $2.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $0.49 Median $912.01 Typical High $2,187.76 | Facility | None | $0.49 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.07 Median $0.36 Typical High $0.44 | Professional | None | $0.07 | $0.36 | $0.44 |
United Setting Professional Modifier None Typical Low $0.15 Median $0.47 Typical High $0.72 | Professional | None | $0.15 | $0.47 | $0.72 |
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 $0.04 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.04 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.04 Typical High $0.06 | Professional | RR · Rental | $0.04 | $0.04 | $0.06 |
Where Indiana sits
The same service costs 3.1 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· 19th of 51
$0.44
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.