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 $0.68 Median $0.79 Typical High $1.17 | Facility | None | $0.68 | $0.79 | $1.17 |
Aetna Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $2.29 | Professional | None | $0.68 | $0.68 | $2.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.17 Median $1.05 Typical High $1.41 | Facility | None | $0.17 | $1.05 | $1.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.24 | Professional | None | $0.09 | $0.09 | $0.24 |
CareSource Setting Facility Modifier None Typical Low $0.30 Median $0.30 Typical High $0.54 | Facility | None | $0.30 | $0.30 | $0.54 |
CareSource Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | None | $0.30 | $0.30 | $0.30 |
Cigna Setting Facility Modifier None Typical Low $0.79 Median $1.95 Typical High $1.95 | Facility | None | $0.79 | $1.95 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $2.24 | Professional | None | $0.71 | $0.71 | $2.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $0.45 Median $1.12 Typical High $1.29 | Facility | None | $0.45 | $1.12 | $1.29 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $2.19 | Professional | None | $0.71 | $0.71 | $2.19 |
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 $0.34 Median $0.34 Typical High $0.34 | Professional | 52 · Reduced service | $0.34 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where Indiana sits
The same service costs 35.5 times more in Oklahoma than in South Carolina. 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· 48th of 51
$0.68
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.