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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $10.72 Typical High $11.22 | Professional | None | $7.59 | $10.72 | $11.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.91 Median $11.22 Typical High $11.48 | Facility | None | $8.91 | $11.22 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $11.48 | Professional | None | $3.98 | $3.98 | $11.48 |
CareSource Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.25 Typical High $6.61 | Professional | None | $5.13 | $5.25 | $6.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $10.23 Median $954.99 Typical High $2,187.76 | Facility | None | $10.23 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.29 Median $10.47 Typical High $12.59 | Professional | None | $2.29 | $10.47 | $12.59 |
United Setting Professional Modifier None Typical Low $4.07 Median $9.33 Typical High $14.13 | Professional | None | $4.07 | $9.33 | $14.13 |
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 $1.12 Median $1.58 Typical High $1.70 | Professional | 55 · Aftercare only | $1.12 | $1.58 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $1.07 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.76 | $1.07 | $1.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.39 Typical High $3.98 | Professional | UE · Used equipment | $3.02 | $3.39 | $3.98 |
Where Indiana sits
The same service costs 4.7 times more in Florida than in New York. 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· 50th of 51
$3.98
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.