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 $6.31 Median $6.31 Typical High $12.59 | Facility | None | $6.31 | $6.31 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.76 | Professional | None | $6.31 | $6.31 | $6.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.29 Median $9.77 Typical High $13.18 | Facility | None | $1.29 | $9.77 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $1.82 | Professional | None | $0.68 | $0.68 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $18.62 Typical High $18.62 | Facility | None | $7.59 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $18.62 | Professional | None | $6.76 | $6.76 | $18.62 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $3.98 Median $10.47 Typical High $16.22 | Facility | None | $3.98 | $10.47 | $16.22 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.13 Median $0.66 Typical High $6.31 | Professional | None | $0.13 | $0.66 | $6.31 |
United Setting Professional Modifier None Typical Low $2.63 Median $6.61 Typical High $11.22 | Professional | None | $2.63 | $6.61 | $11.22 |
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 $3.16 Median $3.16 Typical High $3.39 | Professional | 52 · Reduced service | $3.16 | $3.16 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.26 Typical High $1.35 | Professional | 53 · Discontinued | $1.26 | $1.26 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $0.95 Typical High $1.00 | Professional | 55 · Aftercare only | $0.95 | $0.95 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.63 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.63 | $0.63 | $0.68 |
Where Indiana sits
The same service costs 15.5 times more in Alaska than in Hawaii. 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· 39th of 51
$6.31
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.