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 $8.32 Median $8.32 Typical High $17.78 | Facility | None | $8.32 | $8.32 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.32 Typical High $8.32 | Professional | None | $8.13 | $8.32 | $8.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.71 Median $13.18 Typical High $17.38 | Facility | None | $8.71 | $13.18 | $17.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.71 Typical High $10.96 | Professional | None | $8.13 | $8.71 | $10.96 |
CareSource Setting Facility Modifier None Typical Low $10.72 Median $15.85 Typical High $21.38 | Facility | None | $10.72 | $15.85 | $21.38 |
CareSource Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $20.42 Typical High $22.39 | Facility | None | $11.48 | $20.42 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Professional | None | $8.13 | $8.13 | $8.51 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $14.79 Median $21.38 Typical High $35.48 | Facility | None | $14.79 | $21.38 | $35.48 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $9.12 Median $20.42 Typical High $54.95 | Professional | None | $9.12 | $20.42 | $54.95 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $11.48 | Professional | None | $8.71 | $8.71 | $11.48 |
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 $4.07 Median $4.17 Typical High $4.17 | Professional | 52 · Reduced service | $4.07 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.66 Typical High $1.66 | Professional | 53 · Discontinued | $1.62 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.83 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.81 | $0.83 | $0.83 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | JZ · No drug discarded | $8.13 | $8.13 | $8.13 |
Where Indiana sits
The same service costs 1.9 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· 36th of 51
$8.32
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.