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 $4.57 Median $4.79 Typical High $6.61 | Facility | None | $4.57 | $4.79 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.57 | Professional | None | $4.47 | $4.47 | $4.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.47 Median $6.76 Typical High $9.12 | Facility | None | $4.47 | $6.76 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.47 Typical High $8.13 | Professional | None | $4.17 | $4.47 | $8.13 |
CareSource Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $8.71 | Facility | None | $4.79 | $4.79 | $8.71 |
CareSource Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $12.30 Typical High $12.30 | Facility | None | $5.13 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $19.95 | Professional | None | $4.47 | $4.47 | $19.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $8.32 Median $11.48 Typical High $18.20 | Facility | None | $8.32 | $11.48 | $18.20 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $13.18 | Professional | None | $4.17 | $4.17 | $13.18 |
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 $2.24 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $2.24 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.89 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.46 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.45 | $0.46 | $0.46 |
Where Indiana sits
The same service costs 5.9 times more in Texas than in Rhode Island. 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· 29th of 51
$4.57
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.