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 $72.44 Median $97.72 Typical High $125.89 | Facility | None | $72.44 | $97.72 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $95.50 | Professional | None | $79.43 | $81.28 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $42.66 | Facility | None | $22.39 | $22.39 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $64.57 Typical High $85.11 | Professional | None | $19.05 | $64.57 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $87.10 | Facility | None | $79.43 | $79.43 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $112.20 | Professional | None | $79.43 | $91.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $93.33 Typical High $407.38 | Professional | None | $33.88 | $93.33 | $407.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $123.03 Median $245.47 Typical High $2,137.96 | Facility | None | $123.03 | $245.47 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $162.18 | Professional | None | $81.28 | $109.65 | $162.18 |
United Setting Professional Modifier None Typical Low $38.90 Median $85.11 Typical High $151.36 | Professional | None | $38.90 | $85.11 | $151.36 |
5 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 $39.81 Median $40.74 Typical High $43.65 | Professional | 52 · Reduced service | $39.81 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $17.38 | Professional | 53 · Discontinued | $16.22 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $8.71 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $64.57 Median $64.57 Typical High $91.20 | Professional | GN · Speech therapy plan | $64.57 | $64.57 | $91.20 |
Where Indiana sits
The same service costs 2.9 times more in Alaska 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
$64.57
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.