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 $3.09 Median $3.09 Typical High $6.31 | Facility | None | $3.09 | $3.09 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.24 | Professional | None | $3.09 | $3.09 | $3.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $4.68 Typical High $6.31 | Facility | None | $3.24 | $4.68 | $6.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.16 Typical High $4.79 | Professional | None | $3.09 | $3.16 | $4.79 |
CareSource Setting Facility Modifier None Typical Low $3.16 Median $4.79 Typical High $6.31 | Facility | None | $3.16 | $4.79 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $8.51 Typical High $8.51 | Facility | None | $3.47 | $8.51 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $6.76 | Professional | None | $3.09 | $3.09 | $6.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $4.79 Median $6.17 Typical High $8.91 | Facility | None | $4.79 | $6.17 | $8.91 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.66 Median $4.57 Typical High $5.37 | Professional | None | $0.66 | $4.57 | $5.37 |
United Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $5.89 | Professional | None | $1.26 | $3.16 | $5.89 |
2 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 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.48 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.32 |
Where Indiana sits
The same service costs 3.5 times more in Oklahoma 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· 17th of 51
$3.16
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.