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 $3.72 Median $5.01 Typical High $6.46 | Facility | None | $3.72 | $5.01 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.72 Typical High $5.75 | Professional | None | $3.63 | $3.72 | $5.75 |
Ambetter Setting Professional Modifier None Typical Low $2.00 Median $2.82 Typical High $3.98 | Professional | None | $2.00 | $2.82 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.63 Median $5.50 Typical High $7.24 | Facility | None | $3.63 | $5.50 | $7.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $6.46 | Professional | None | $3.31 | $3.63 | $6.46 |
CareSource Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $5.37 | Facility | None | $2.95 | $2.95 | $5.37 |
CareSource Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $10.00 Typical High $10.00 | Facility | None | $4.07 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $9.12 | Professional | None | $3.63 | $3.63 | $9.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $5.75 Median $7.08 Typical High $10.72 | Facility | None | $5.75 | $7.08 | $10.72 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.72 Typical High $10.47 | Professional | None | $3.31 | $3.72 | $10.47 |
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 $1.82 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.74 Typical High $0.74 | Professional | 53 · Discontinued | $0.72 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 55 · Aftercare only | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.36 | $0.37 | $0.37 |
Where Indiana sits
The same service costs 2.5 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· 14th of 51
$3.89
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.