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 $9.55 Median $12.88 Typical High $19.05 | Facility | None | $9.55 | $12.88 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $9.33 Typical High $21.88 | Facility | None | $3.24 | $9.33 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $27.54 Typical High $50.12 | Professional | None | $22.91 | $27.54 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $17.78 Median $32.36 Typical High $35.48 | Facility | None | $17.78 | $32.36 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $25.70 Typical High $28.18 | Facility | None | $11.22 | $25.70 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $29.51 | Professional | None | $10.23 | $10.23 | $29.51 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $6.31 Median $16.22 Typical High $16.98 | Facility | None | $6.31 | $16.22 | $16.98 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $31.62 | Professional | None | $10.00 | $10.00 | $31.62 |
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 $4.79 Median $4.79 Typical High $4.79 | Professional | 52 · Reduced service | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | 53 · Discontinued | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $0.95 |
Where Indiana sits
The same service costs 9.1 times more in Alabama 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· 7th of 51
$19.95
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.