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 $5.37 Median $6.46 Typical High $9.33 | Facility | None | $5.37 | $6.46 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | None | $5.25 | $5.37 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.25 Median $7.94 Typical High $10.47 | Facility | None | $5.25 | $7.94 | $10.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $6.61 | Professional | None | $4.90 | $5.25 | $6.61 |
CareSource Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $12.02 | Facility | None | $6.76 | $6.76 | $12.02 |
CareSource Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $7.41 | Professional | None | $6.76 | $6.76 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $14.45 Typical High $14.45 | Facility | None | $7.41 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.31 | Professional | None | $5.25 | $5.25 | $6.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $9.77 Median $13.49 Typical High $18.20 | Facility | None | $9.77 | $13.49 | $18.20 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $5.89 Median $9.33 Typical High $15.49 | Professional | None | $5.89 | $9.33 | $15.49 |
United Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.75 | Professional | None | $4.90 | $4.90 | $5.75 |
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 $2.63 Median $2.69 Typical High $2.69 | Professional | 52 · Reduced service | $2.63 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | JZ · No drug discarded | $4.90 | $4.90 | $4.90 |
Where Indiana sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 40th of 51
$5.25
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.