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 $2.19 Median $3.24 Typical High $4.17 | Facility | None | $2.19 | $3.24 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.02 | Professional | None | $2.19 | $2.19 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.19 Median $3.31 Typical High $4.37 | Facility | None | $2.19 | $3.31 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $3.89 | Professional | None | $2.04 | $2.19 | $3.89 |
CareSource Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $4.27 | Facility | None | $2.34 | $2.34 | $4.27 |
CareSource Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Cigna Setting Facility Modifier None Typical Low $2.45 Median $6.03 Typical High $6.03 | Facility | None | $2.45 | $6.03 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $6.31 | Professional | None | $2.19 | $2.19 | $6.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2.09 Median $4.17 Typical High $6.31 | Facility | None | $2.09 | $4.17 | $6.31 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $6.31 | Professional | None | $2.04 | $2.04 | $6.31 |
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 $1.10 Median $1.12 Typical High $1.12 | Professional | 52 · Reduced service | $1.10 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.22 |
Where Indiana sits
Rates are fairly even across states for this service. 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· 20th of 51
$2.24
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.