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 $3.09 Median $3.09 Typical High $6.61 | Facility | None | $3.09 | $3.09 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.09 Typical High $3.24 | Professional | None | $3.02 | $3.09 | $3.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $4.90 Typical High $6.61 | Facility | None | $3.24 | $4.90 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.24 Typical High $5.89 | Professional | None | $3.02 | $3.24 | $5.89 |
CareSource Setting Facility Modifier None Typical Low $4.68 Median $7.08 Typical High $9.33 | Facility | None | $4.68 | $7.08 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $7.59 Typical High $8.32 | Facility | None | $3.47 | $7.59 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.63 Typical High $3.98 | Professional | None | $3.02 | $3.63 | $3.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $6.61 Median $10.72 Typical High $12.30 | Facility | None | $6.61 | $10.72 | $12.30 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $10.23 | Professional | None | $3.24 | $3.24 | $10.23 |
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 $1.51 Median $1.55 Typical High $1.55 | Professional | 52 · Reduced service | $1.51 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.31 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.30 | $0.31 | $0.31 |
Where Indiana sits
The same service costs 6.0 times more in Wyoming 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
$3.63
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.