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 $5.13 Median $5.13 Typical High $10.47 | Facility | None | $5.13 | $5.13 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $7.76 Typical High $10.23 | Facility | None | $5.13 | $7.76 | $10.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $10.00 | Professional | None | $5.13 | $5.13 | $10.00 |
CareSource Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $9.77 | Facility | None | $5.50 | $5.50 | $9.77 |
CareSource Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $12.30 Typical High $14.13 | Facility | None | $5.75 | $12.30 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $13.49 | Professional | None | $5.13 | $5.13 | $13.49 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $6.03 Median $10.23 Typical High $15.49 | Facility | None | $6.03 | $10.23 | $15.49 |
United Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $16.22 | Professional | None | $5.13 | $5.13 | $16.22 |
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 $2.57 Median $2.57 Typical High $2.57 | Professional | 52 · Reduced service | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.05 Typical High $1.05 | Professional | 53 · Discontinued | $1.02 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.51 | $0.52 | $0.52 |
Where Indiana sits
The same service costs 1.7 times more in Arizona 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· 19th of 51
$5.62
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.