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 $3.55 Median $4.07 Typical High $5.37 | Facility | None | $3.55 | $4.07 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.02 | Professional | None | $2.95 | $2.95 | $3.02 |
Ambetter Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.95 | Professional | None | $2.29 | $2.29 | $2.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.09 Median $4.37 Typical High $5.89 | Facility | None | $3.09 | $4.37 | $5.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $5.01 Typical High $5.50 | Professional | None | $2.95 | $5.01 | $5.50 |
CareSource Setting Facility Modifier None Typical Low $2.82 Median $4.27 Typical High $5.62 | Facility | None | $2.82 | $4.27 | $5.62 |
CareSource Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $8.13 Typical High $8.13 | Facility | None | $4.07 | $8.13 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.95 Typical High $3.02 | Professional | None | $2.57 | $2.95 | $3.02 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $4.47 Median $5.89 Typical High $8.13 | Facility | None | $4.47 | $5.89 | $8.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.14 Median $3.24 Typical High $7.08 | Professional | None | $2.14 | $3.24 | $7.08 |
United Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $3.47 | Professional | None | $2.69 | $2.69 | $3.47 |
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 $1.48 Median $1.48 Typical High $1.48 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.45 Typical High $0.45 | Professional | 55 · Aftercare only | $0.44 | $0.45 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.28 | $0.30 | $0.30 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | JZ · No drug discarded | $3.89 | $3.89 | $3.89 |
Where Indiana sits
Rates are fairly even across states for this service. 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· 9th of 51
$3.09
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.