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 $11.75 Median $19.05 Typical High $28.18 | Facility | None | $11.75 | $19.05 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.75 Typical High $11.75 | Professional | None | $11.48 | $11.75 | $11.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $20.42 Typical High $28.18 | Facility | None | $13.80 | $20.42 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $13.80 Typical High $15.49 | Professional | None | $11.48 | $13.80 | $15.49 |
CareSource Setting Facility Modifier None Typical Low $12.30 Median $18.62 Typical High $24.55 | Facility | None | $12.30 | $18.62 | $24.55 |
CareSource Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $28.84 Typical High $31.62 | Facility | None | $15.85 | $28.84 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $30.90 | Professional | None | $11.48 | $11.48 | $30.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $23.44 Median $28.18 Typical High $46.77 | Facility | None | $23.44 | $28.18 | $46.77 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $14.13 Median $21.38 Typical High $28.18 | Professional | None | $14.13 | $21.38 | $28.18 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $18.20 | Professional | None | $13.80 | $13.80 | $18.20 |
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 $5.75 Median $5.89 Typical High $5.89 | Professional | 52 · Reduced service | $5.75 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.34 Typical High $2.34 | Professional | 53 · Discontinued | $2.29 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.78 Typical High $1.78 | Professional | 55 · Aftercare only | $1.74 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.17 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.15 | $1.17 | $1.17 |
Where Indiana sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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
$11.75
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.