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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $50.12 | Professional | None | $37.15 | $42.66 | $50.12 |
Aetna Setting Professional Modifier RR · Rental Typical Low $3.55 Median $3.55 Typical High $5.01 | Professional | RR · Rental | $3.55 | $3.55 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $67.61 Typical High $72.44 | Facility | None | $53.70 | $67.61 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $67.61 | Professional | None | $42.66 | $42.66 | $67.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $5.37 | Professional | RR · Rental | $4.27 | $4.27 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $38.90 | Professional | UE · Used equipment | $31.62 | $31.62 | $38.90 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Facility | None | $95.50 | $95.50 | $100.00 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $47.86 | Facility | None | $44.67 | $44.67 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $331.13 | Professional | None | $38.02 | $38.02 | $331.13 |
Cigna Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | RR · Rental | $109.65 | $109.65 | $109.65 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $102.33 Median $213.80 Typical High $2,187.76 | Facility | None | $102.33 | $213.80 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $104.71 | Professional | None | $44.67 | $66.07 | $104.71 |
United Setting Professional Modifier None Typical Low $21.38 Median $34.67 Typical High $66.07 | Professional | None | $21.38 | $34.67 | $66.07 |
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 $5.89 Median $6.46 Typical High $7.59 | Professional | 55 · Aftercare only | $5.89 | $6.46 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.27 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.98 | $4.27 | $5.01 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $3.55 Median $3.55 Typical High $5.01 | Professional | MS · Maintenance fee | $3.55 | $3.55 | $5.01 |
Where Indiana sits
The same service costs 2.5 times more in Wyoming than in Florida. 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· 36th of 51
$42.66
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.