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 $0.87 Median $0.87 Typical High $2.04 | Facility | None | $0.87 | $0.87 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $0.87 Typical High $0.87 | Professional | None | $0.85 | $0.87 | $0.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.89 Median $1.51 Typical High $2.04 | Facility | None | $0.89 | $1.51 | $2.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.85 Median $1.00 Typical High $1.12 | Professional | None | $0.85 | $1.00 | $1.12 |
CareSource Setting Facility Modifier None Typical Low $0.79 Median $1.20 Typical High $1.58 | Facility | None | $0.79 | $1.20 | $1.58 |
CareSource Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Cigna Setting Facility Modifier None Typical Low $0.98 Median $2.34 Typical High $2.34 | Facility | None | $0.98 | $2.34 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $4.27 | Professional | None | $0.85 | $0.85 | $4.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1.23 Median $1.91 Typical High $3.02 | Facility | None | $1.23 | $1.91 | $3.02 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.63 Median $1.26 Typical High $3.39 | Professional | None | $0.63 | $1.26 | $3.39 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.07 | Professional | None | $1.00 | $1.00 | $1.07 |
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 $0.43 Median $0.44 Typical High $0.44 | Professional | 52 · Reduced service | $0.43 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Where Indiana sits
The same service costs 3.7 times more in North Carolina than in Virginia. 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· 27th of 51
$0.87
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.