How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $5.89 Median $8.32 Typical High $9.77 | Facility | None | $5.89 | $8.32 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $10.47 | Professional | None | $5.89 | $5.89 | $10.47 |
Ambetter Setting Professional Modifier None Typical Low $8.51 Median $12.59 Typical High $22.91 | Professional | None | $8.51 | $12.59 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $27.54 | Facility | None | $14.13 | $14.13 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $19.95 | Professional | None | $14.13 | $14.13 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.41 Median $1.41 Typical High $2.00 | Professional | RR · Rental | $1.41 | $1.41 | $2.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.72 Median $10.72 Typical High $14.45 | Professional | UE · Used equipment | $10.72 | $10.72 | $14.45 |
CareSource Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $42.66 | Facility | None | $10.96 | $10.96 | $42.66 |
CareSource Setting Professional Modifier None Typical Low $10.96 Median $14.45 Typical High $15.49 | Professional | None | $10.96 | $14.45 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $23.44 | Facility | None | $20.89 | $20.89 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $18.62 Typical High $60.26 | Professional | None | $15.49 | $18.62 | $60.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,290.87 | Facility | None | $912.01 | $2,089.30 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $10.23 Median $13.18 Typical High $20.89 | Professional | None | $10.23 | $13.18 | $20.89 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.94 Typical High $12.59 | Professional | None | $5.37 | $7.94 | $12.59 |
4 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 52 · Reduced service Typical Low $2.95 Median $2.95 Typical High $3.72 | Professional | 52 · Reduced service | $2.95 | $2.95 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $1.48 | Professional | 53 · Discontinued | $1.20 | $1.20 | $1.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $1.10 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $0.74 |
Where Indiana sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 24th of 51
$14.13
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.