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 $24.55 Median $33.88 Typical High $46.77 | Facility | None | $24.55 | $33.88 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $25.12 | Professional | None | $24.55 | $24.55 | $25.12 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $37.15 Typical High $48.98 | Facility | None | $23.99 | $37.15 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $24.55 Typical High $31.62 | Professional | None | $23.99 | $24.55 | $31.62 |
CareSource Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $50.12 | Facility | None | $27.54 | $27.54 | $50.12 |
CareSource Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $30.90 | Professional | None | $27.54 | $27.54 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $61.66 Typical High $67.61 | Facility | None | $34.67 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $72.44 | Professional | None | $24.55 | $24.55 | $72.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $47.86 Median $57.54 Typical High $75.86 | Facility | None | $47.86 | $57.54 | $75.86 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $25.12 Median $53.70 Typical High $67.61 | Professional | None | $25.12 | $53.70 | $67.61 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $31.62 | Professional | None | $23.99 | $23.99 | $31.62 |
4 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 $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $4.90 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Where Indiana sits
The same service costs 2.8 times more in Wyoming than in North Carolina. 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· 44th of 51
$24.55
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.