How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $13.80 Median $13.80 Typical High $21.38 | Facility | None | $13.80 | $13.80 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $9.12 Typical High $20.89 | Professional | None | $5.37 | $9.12 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $8.51 Typical High $18.62 | Professional | None | $6.31 | $8.51 | $18.62 |
CareSource Setting Professional Modifier None Typical Low $6.17 Median $9.55 Typical High $10.96 | Professional | None | $6.17 | $9.55 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $6.46 Typical High $6.46 | Professional | None | $3.72 | $6.46 | $6.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.72 Median $3.09 Typical High $3.63 | Professional | None | $0.72 | $3.09 | $3.63 |
United Setting Professional Modifier None Typical Low $8.71 Median $12.02 Typical High $22.91 | Professional | None | $8.71 | $12.02 | $22.91 |
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 $4.27 Median $4.57 Typical High $6.03 | Professional | 52 · Reduced service | $4.27 | $4.57 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.82 Typical High $2.40 | Professional | 53 · Discontinued | $1.70 | $1.82 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.38 Typical High $1.82 | Professional | 55 · Aftercare only | $1.26 | $1.38 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.91 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.85 | $0.91 | $1.20 |
Ambetter Setting Professional Modifier LR · Lab round trip Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | LR · Lab round trip | $5.01 | $5.01 | $5.01 |
Where Indiana sits
The same service costs 25.1 times more in Wyoming than in New Jersey. 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· 16th of 51
$10.23
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.