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 $4.07 Median $4.27 Typical High $8.51 | Facility | None | $4.07 | $4.27 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $5.37 | Professional | None | $4.17 | $4.17 | $5.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.04 Median $2.04 Typical High $2.57 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $1.02 | Professional | 53 · Discontinued | $0.83 | $0.83 | $1.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.78 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.51 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $4.47 Typical High $6.31 | Professional | None | $3.80 | $4.47 | $6.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.89 Median $114.82 Typical High $151.36 | Facility | None | $5.89 | $114.82 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.68 Typical High $5.89 | Professional | None | $4.17 | $4.68 | $5.89 |
CareSource Setting Facility Modifier None Typical Low $3.89 Median $4.07 Typical High $4.37 | Facility | None | $3.89 | $4.07 | $4.37 |
CareSource Setting Professional Modifier None Typical Low $3.55 Median $4.27 Typical High $5.62 | Professional | None | $3.55 | $4.27 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $6.61 | Professional | None | $3.02 | $3.98 | $6.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $12.30 Median $912.01 Typical High $2,187.76 | Facility | None | $12.30 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3.16 Median $4.37 Typical High $7.59 | Professional | None | $3.16 | $4.37 | $7.59 |
United Setting Professional Modifier None Typical Low $4.07 Median $5.25 Typical High $8.32 | Professional | None | $4.07 | $5.25 | $8.32 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | 59 · Distinct service | $3.80 | $3.80 | $5.13 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | SA · Nurse practitioner | $4.07 | $4.07 | $4.07 |
Where Indiana sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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
$4.68
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.