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 $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $22.91 | Professional | None | $3.02 | $3.02 | $22.91 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $218.78 Typical High $295.12 | Facility | None | $25.70 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $25.70 Typical High $33.88 | Professional | None | $16.22 | $25.70 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $27.54 | Facility | None | $15.14 | $15.14 | $27.54 |
CareSource Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $15.85 Typical High $33.88 | Professional | None | $6.76 | $15.85 | $33.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $13.49 Median $48.98 Typical High $2,187.76 | Facility | None | $13.49 | $48.98 | $2,187.76 |
United Setting Professional Modifier None Typical Low $10.00 Median $14.45 Typical High $22.39 | Professional | None | $10.00 | $14.45 | $22.39 |
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 $1.51 Median $1.51 Typical High $1.51 | Professional | 52 · Reduced service | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | 53 · Discontinued | $0.60 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Where Indiana sits
The same service costs 5.2 times more in Texas 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· 18th of 51
$21.38
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.