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 $0.36 Median $0.36 Typical High $0.36 | Facility | None | $0.36 | $0.36 | $0.36 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.76 | Professional | None | $0.36 | $0.36 | $0.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.62 Median $0.78 Typical High $0.87 | Facility | None | $0.62 | $0.78 | $0.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.50 Median $0.59 Typical High $0.78 | Professional | None | $0.50 | $0.59 | $0.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | RR · Rental | $0.05 | $0.05 | $0.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.38 Median $0.50 Typical High $0.59 | Professional | UE · Used equipment | $0.38 | $0.50 | $0.59 |
CareSource Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.12 | Facility | None | $1.10 | $1.10 | $1.12 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.45 Typical High $0.78 | Facility | None | $0.42 | $0.45 | $0.78 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.45 Typical High $3.39 | Professional | None | $0.36 | $0.45 | $3.39 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1.15 Median $2.45 Typical High $2,187.76 | Facility | None | $1.15 | $2.45 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.49 Median $0.63 Typical High $1.07 | Professional | None | $0.49 | $0.63 | $1.07 |
United Setting Professional Modifier None Typical Low $0.22 Median $0.37 Typical High $0.62 | Professional | None | $0.22 | $0.37 | $0.62 |
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 $0.18 Median $0.18 Typical High $0.38 | Professional | 52 · Reduced service | $0.18 | $0.18 | $0.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.15 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.11 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.08 |
Where Indiana sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 23rd of 51
$0.52
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.