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 $3.63 Median $3.63 Typical High $5.89 | Facility | None | $3.63 | $3.63 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $3.63 Typical High $3.63 | Professional | None | $2.19 | $3.63 | $3.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.71 Median $0.71 Typical High $1.35 | Facility | None | $0.71 | $0.71 | $1.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.71 Median $0.78 Typical High $12.88 | Professional | None | $0.71 | $0.78 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $10.23 Typical High $10.23 | Facility | None | $4.17 | $10.23 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $10.00 | Professional | None | $3.72 | $3.72 | $10.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
United Setting Professional Modifier None Typical Low $1.86 Median $3.98 Typical High $8.13 | Professional | None | $1.86 | $3.98 | $8.13 |
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 $1.12 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.12 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.72 Typical High $0.72 | Professional | 53 · Discontinued | $0.44 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.33 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.22 | $0.36 | $0.36 |
Where Indiana sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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
$2.82
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.