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 $3.02 Median $3.98 Typical High $5.50 | Facility | None | $3.02 | $3.98 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.95 | Professional | None | $2.88 | $2.88 | $2.95 |
Ambetter Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.24 | Professional | None | $2.88 | $2.88 | $3.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.02 Median $4.90 Typical High $6.46 | Facility | None | $3.02 | $4.90 | $6.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $3.24 Typical High $3.89 | Professional | None | $2.88 | $3.24 | $3.89 |
CareSource Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $5.62 | Facility | None | $3.16 | $3.16 | $5.62 |
CareSource Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.47 | Professional | None | $3.16 | $3.16 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $7.94 Typical High $7.94 | Facility | None | $4.07 | $7.94 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.63 | Professional | None | $2.88 | $2.88 | $3.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $5.75 Median $6.46 Typical High $10.96 | Facility | None | $5.75 | $6.46 | $10.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3.55 Median $7.94 Typical High $10.00 | Professional | None | $3.55 | $7.94 | $10.00 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $5.50 | Professional | None | $3.24 | $3.24 | $5.50 |
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 $1.45 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.44 Typical High $0.44 | Professional | 55 · Aftercare only | $0.43 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Where Indiana sits
The same service costs 3.1 times more in Wyoming than in Delaware. 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· 47th of 51
$2.88
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.