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 $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $54.95 | Professional | None | $28.18 | $28.18 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $47.86 | Facility | None | $25.12 | $25.12 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $25.12 Typical High $31.62 | Professional | None | $12.02 | $25.12 | $31.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.51 Typical High $3.55 | Professional | RR · Rental | $2.51 | $2.51 | $3.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.62 Median $18.62 Typical High $27.54 | Professional | UE · Used equipment | $18.62 | $18.62 | $27.54 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $13.49 | Facility | None | $12.59 | $12.59 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $33.11 | Professional | None | $10.72 | $10.72 | $33.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $8.91 Median $13.18 Typical High $21.88 | Professional | None | $8.91 | $13.18 | $21.88 |
2 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 $4.27 Median $4.27 Typical High $8.32 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $5.50 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $5.50 |
Where Indiana sits
The same service costs 3.5 times more in North Dakota than in Oklahoma. 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· 4th of 51
$25.12
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.