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 $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $7.24 Typical High $7.24 | Professional | None | $4.68 | $7.24 | $7.24 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $6.76 | Facility | None | $3.47 | $3.47 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $8.51 | Professional | None | $3.47 | $3.47 | $8.51 |
CareSource Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.59 | Facility | None | $12.30 | $12.30 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $53.70 | Professional | None | $3.47 | $3.47 | $53.70 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $7.59 Median $27.54 Typical High $2,137.96 | Facility | None | $7.59 | $27.54 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $5.50 Median $6.92 Typical High $12.59 | Professional | None | $5.50 | $6.92 | $12.59 |
United Setting Professional Modifier None Typical Low $2.40 Median $4.17 Typical High $7.08 | Professional | None | $2.40 | $4.17 | $7.08 |
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 $2.34 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $2.34 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $0.95 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.55 Median $5.37 Typical High $5.37 | Professional | 54 · Surgery only | $3.55 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $0.71 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.47 | $0.72 | $0.72 |
Where Indiana sits
The same service costs 4.1 times more in Rhode Island than in New York. 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
$4.07
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.