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 $15.14 Typical High $20.89 | Facility | None | $10.00 | $15.14 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.23 Typical High $25.70 | Professional | None | $10.00 | $10.23 | $25.70 |
Ambetter Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | None | $12.88 | $12.88 | $15.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $23.99 | Facility | None | $12.59 | $12.59 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $12.59 Typical High $22.39 | Professional | None | $10.72 | $12.59 | $22.39 |
CareSource Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $23.99 | Facility | None | $13.49 | $13.49 | $23.99 |
CareSource Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $12.02 Typical High $18.20 | Professional | None | $5.89 | $12.02 | $18.20 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $12.02 Median $45.71 Typical High $2,187.76 | Facility | None | $12.02 | $45.71 | $2,187.76 |
United Setting Professional Modifier None Typical Low $10.00 Median $12.30 Typical High $18.20 | Professional | None | $10.00 | $12.30 | $18.20 |
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 5.6 times more in Alabama than in Kentucky. 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
$12.59
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.