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 $3.63 Median $4.90 Typical High $6.76 | Facility | None | $3.63 | $4.90 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.63 Typical High $3.63 | Professional | None | $3.55 | $3.63 | $3.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $5.37 Typical High $7.08 | Facility | None | $3.55 | $5.37 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $5.50 | Professional | None | $3.39 | $3.55 | $5.50 |
CareSource Setting Facility Modifier None Typical Low $3.55 Median $5.25 Typical High $7.08 | Facility | None | $3.55 | $5.25 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $9.77 Typical High $9.77 | Facility | None | $3.98 | $9.77 | $9.77 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $14.79 | Professional | None | $3.55 | $3.55 | $14.79 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $6.76 Median $8.91 Typical High $13.49 | Facility | None | $6.76 | $8.91 | $13.49 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $10.72 | Professional | None | $3.39 | $3.39 | $10.72 |
5 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 $1.78 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.78 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.72 Typical High $0.72 | Professional | 53 · Discontinued | $0.71 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.52 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | JZ · No drug discarded | $3.39 | $3.39 | $3.39 |
Where Indiana sits
The same service costs 4.0 times more in Oklahoma than in Maryland. 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· 30th of 51
$3.72
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.