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 $0.12 Median $0.12 Typical High $0.24 | Facility | None | $0.12 | $0.12 | $0.24 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | None | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.08 Median $0.20 Typical High $0.26 | Facility | None | $0.08 | $0.20 | $0.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.04 Median $0.04 Typical High $0.06 | Professional | None | $0.04 | $0.04 | $0.06 |
CareSource Setting Facility Modifier None Typical Low $1.70 Median $1.78 Typical High $3.09 | Facility | None | $1.70 | $1.78 | $3.09 |
CareSource Setting Professional Modifier None Typical Low $1.70 Median $1.78 Typical High $2.19 | Professional | None | $1.70 | $1.78 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $0.15 Median $0.36 Typical High $0.36 | Facility | None | $0.15 | $0.36 | $0.36 |
Cigna Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.15 | Professional | None | $0.13 | $0.13 | $0.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $0.12 Median $912.01 Typical High $2,137.96 | Facility | None | $0.12 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.07 Median $0.10 Typical High $0.43 | Professional | None | $0.07 | $0.10 | $0.43 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | None | $0.13 | $0.13 | $0.14 |
1 more rate 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 56 · Pre-op care only Typical Low $0.02 Median $0.30 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.02 | $0.30 | $0.40 |
Where Indiana sits
The same service costs 32.4 times more in Montana than in Hawaii. 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· 49th of 51
$0.12
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.