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 $0.45 Median $0.45 Typical High $0.89 | Facility | None | $0.45 | $0.45 | $0.89 |
Aetna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.46 | Professional | None | $0.45 | $0.45 | $0.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.56 Median $0.74 Typical High $1.07 | Facility | None | $0.56 | $0.74 | $1.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.85 | Professional | None | $0.56 | $0.56 | $0.85 |
CareSource Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $10.96 | Facility | None | $3.98 | $3.98 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $10.72 | Professional | None | $3.98 | $3.98 | $10.72 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.91 Median $3.47 Typical High $4.57 | Professional | None | $0.91 | $3.47 | $4.57 |
United Setting Professional Modifier None Typical Low $1.86 Median $4.68 Typical High $7.94 | Professional | None | $1.86 | $4.68 | $7.94 |
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 $0.23 Median $0.23 Typical High $0.24 | Professional | 52 · Reduced service | $0.23 | $0.23 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Indiana sits
The same service costs 58.9 times more in Montana 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· 37th of 51
$0.69
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.