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 $13.18 Median $13.18 Typical High $26.92 | Facility | None | $13.18 | $13.18 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.00 Median $1.32 Typical High $1.95 | Facility | None | $1.00 | $1.32 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.82 | Professional | None | $1.00 | $1.00 | $1.82 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.91 | Professional | None | $1.32 | $1.32 | $1.91 |
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 $6.61 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 53 · Discontinued | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.32 |
Where Indiana sits
The same service costs 1412.5 times more in Wyoming than in Missouri. 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· 43rd of 51
$1.10
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.