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 $32.36 Median $38.90 Typical High $38.90 | Facility | None | $32.36 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $48.98 | Professional | None | $32.36 | $32.36 | $48.98 |
Ambetter Setting Professional Modifier None Typical Low $23.44 Median $24.55 Typical High $28.84 | Professional | None | $23.44 | $24.55 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $45.71 Typical High $61.66 | Facility | None | $28.84 | $45.71 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $56.23 | Professional | None | $30.90 | $34.67 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $34.67 | Facility | None | $19.05 | $19.05 | $34.67 |
CareSource Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $95.50 Typical High $95.50 | Facility | None | $38.90 | $95.50 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $89.13 | Professional | None | $34.67 | $34.67 | $89.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $30.90 Median $46.77 Typical High $2,089.30 | Facility | None | $30.90 | $46.77 | $2,089.30 |
United Setting Professional Modifier None Typical Low $30.90 Median $35.48 Typical High $52.48 | Professional | None | $30.90 | $35.48 | $52.48 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where Indiana sits
The same service costs 5.4 times more in Arizona than in Rhode Island. 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· 28th of 51
$34.67
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.