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 $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $11.75 | Professional | None | $8.51 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $4.68 Typical High $5.89 | Professional | 52 · Reduced service | $4.27 | $4.68 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.86 Typical High $2.34 | Professional | 53 · Discontinued | $1.70 | $1.86 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.41 Typical High $1.78 | Professional | 55 · Aftercare only | $1.29 | $1.41 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.93 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.85 | $0.93 | $1.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.00 Median $12.59 Typical High $12.59 | Facility | None | $10.00 | $12.59 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $9.77 | Professional | None | $5.25 | $5.25 | $9.77 |
CareSource Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $22.39 | Facility | None | $21.38 | $21.38 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $19.05 Median $39.81 Typical High $2,187.76 | Facility | None | $19.05 | $39.81 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $7.94 Median $12.02 Typical High $14.13 | Professional | None | $7.94 | $12.02 | $14.13 |
United Setting Professional Modifier None Typical Low $3.98 Median $4.79 Typical High $7.94 | Professional | None | $3.98 | $4.79 | $7.94 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.98 Median $5.25 Typical High $9.33 | Professional | UE · Used equipment | $3.98 | $5.25 | $9.33 |
Where Indiana sits
The same service costs 2.7 times more in Montana than in Utah. 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
$6.03
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.