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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $10.96 Typical High $11.48 | Professional | None | $7.94 | $10.96 | $11.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.12 Median $11.48 Typical High $11.75 | Facility | None | $9.12 | $11.48 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $11.75 | Professional | None | $4.17 | $4.17 | $11.75 |
CareSource Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
CareSource Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.02 | Professional | None | $10.47 | $10.47 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.50 Typical High $5.50 | Professional | None | $5.13 | $5.50 | $5.50 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $10.72 Median $954.99 Typical High $2,187.76 | Facility | None | $10.72 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.40 Median $10.96 Typical High $12.88 | Professional | None | $2.40 | $10.96 | $12.88 |
United Setting Professional Modifier None Typical Low $4.27 Median $9.55 Typical High $14.79 | Professional | None | $4.27 | $9.55 | $14.79 |
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 $1.17 Median $1.66 Typical High $1.74 | Professional | 55 · Aftercare only | $1.17 | $1.66 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $1.12 Typical High $1.15 | Professional | 56 · Pre-op care only | $0.79 | $1.12 | $1.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.09 Median $3.09 Typical High $6.17 | Professional | UE · Used equipment | $3.09 | $3.09 | $6.17 |
Where Indiana sits
The same service costs 4.6 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
$4.17
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.