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 $11.48 Median $16.98 Typical High $21.38 | Facility | None | $11.48 | $16.98 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | None | $11.48 | $11.48 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $17.38 Typical High $23.44 | Facility | None | $11.75 | $17.38 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.75 Typical High $21.88 | Professional | None | $11.48 | $11.75 | $21.88 |
CareSource Setting Facility Modifier None Typical Low $12.88 Median $19.50 Typical High $25.70 | Facility | None | $12.88 | $19.50 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $30.90 Typical High $31.62 | Facility | None | $12.88 | $30.90 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $35.48 | Professional | None | $11.48 | $11.48 | $35.48 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $14.79 Median $25.70 Typical High $37.15 | Facility | None | $14.79 | $25.70 | $37.15 |
United Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $36.31 | Professional | None | $11.75 | $11.75 | $36.31 |
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 $5.62 Median $5.75 Typical High $5.75 | Professional | 52 · Reduced service | $5.62 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.70 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $1.15 |
Where Indiana sits
The same service costs 1.8 times more in Alaska than in Georgia. 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· 19th of 51
$12.88
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.