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 $10.00 Median $12.88 Typical High $28.84 | Facility | None | $10.00 | $12.88 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $38.90 | Professional | None | $10.00 | $12.02 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $16.60 Median $20.89 Typical High $25.12 | Professional | None | $16.60 | $20.89 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.85 Median $218.78 Typical High $295.12 | Facility | None | $15.85 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $21.38 Typical High $33.88 | Professional | None | $13.49 | $21.38 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $33.88 | Facility | None | $18.62 | $18.62 | $33.88 |
CareSource Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $19.95 Typical High $33.88 | Professional | None | $8.71 | $19.95 | $33.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $16.60 Median $63.10 Typical High $2,187.76 | Facility | None | $16.60 | $63.10 | $2,187.76 |
United Setting Professional Modifier None Typical Low $13.49 Median $19.50 Typical High $28.84 | Professional | None | $13.49 | $19.50 | $28.84 |
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 $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Indiana sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 38th of 51
$20.89
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.