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 $3.39 Median $4.68 Typical High $6.31 | Facility | None | $3.39 | $4.68 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $16.22 | Professional | None | $3.39 | $3.39 | $16.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $6.76 Typical High $61.66 | Facility | None | $3.55 | $6.76 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $22.91 Typical High $46.77 | Professional | None | $3.39 | $22.91 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $9.12 | Facility | None | $5.01 | $5.01 | $9.12 |
CareSource Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $9.33 Typical High $9.33 | Facility | None | $4.68 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $17.78 | Professional | None | $3.39 | $3.39 | $17.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $10.00 Median $16.22 Typical High $912.01 | Facility | None | $10.00 | $16.22 | $912.01 |
United Setting Professional Modifier None Typical Low $30.90 Median $52.48 Typical High $97.72 | Professional | None | $30.90 | $52.48 | $97.72 |
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 $1.70 Median $1.70 Typical High $1.70 | Professional | 52 · Reduced service | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.51 Typical High $0.51 | Professional | 55 · Aftercare only | $0.50 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $0.34 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | JZ · No drug discarded | $30.90 | $30.90 | $30.90 |
Where Indiana sits
The same service costs 9.1 times more in Vermont 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· 21st of 51
$10.23
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.