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 $4.47 Median $4.47 Typical High $8.51 | Facility | None | $4.47 | $4.47 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.47 Typical High $4.47 | Professional | None | $4.37 | $4.47 | $4.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.27 Median $6.61 Typical High $8.71 | Facility | None | $4.27 | $6.61 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $8.13 | Professional | None | $4.27 | $4.37 | $8.13 |
CareSource Setting Facility Modifier None Typical Low $4.27 Median $6.31 Typical High $8.51 | Facility | None | $4.27 | $6.31 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $10.96 Typical High $12.02 | Facility | None | $5.01 | $10.96 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $10.72 | Professional | None | $4.37 | $4.37 | $10.72 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $5.89 Median $8.51 Typical High $12.02 | Facility | None | $5.89 | $8.51 | $12.02 |
United Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $13.49 | Professional | None | $4.27 | $4.27 | $13.49 |
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 $2.19 Median $2.24 Typical High $2.24 | Professional | 52 · Reduced service | $2.19 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.89 Typical High $0.89 | Professional | 53 · Discontinued | $0.87 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $0.44 |
Where Indiana sits
The same service costs 2.7 times more in Alaska than in Oklahoma. 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· 15th 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.