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 $4.27 Median $6.46 Typical High $7.94 | Facility | None | $4.27 | $6.46 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $6.46 | Professional | None | $4.27 | $4.27 | $6.46 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.47 Median $7.08 Typical High $9.33 | Facility | None | $4.47 | $7.08 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.68 Typical High $8.51 | Professional | None | $4.27 | $4.68 | $8.51 |
CareSource Setting Facility Modifier None Typical Low $4.47 Median $6.76 Typical High $8.91 | Facility | None | $4.47 | $6.76 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $11.75 Typical High $11.75 | Facility | None | $4.79 | $11.75 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $25.70 | Professional | None | $4.27 | $4.27 | $25.70 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $8.51 Median $11.22 Typical High $18.62 | Facility | None | $8.51 | $11.22 | $18.62 |
United Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $14.79 | Professional | None | $4.68 | $4.68 | $14.79 |
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 $2.14 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.63 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.42 | $0.43 | $0.43 |
Where Indiana sits
The same service costs 3.4 times more in Texas than in Georgia. 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
$4.90
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.