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 $5.75 Median $8.71 Typical High $25.70 | Facility | None | $5.75 | $8.71 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $11.75 | Professional | None | $5.25 | $5.75 | $11.75 |
Ambetter Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.50 Median $7.08 Typical High $20.89 | Facility | None | $5.50 | $7.08 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.57 Typical High $5.25 | Professional | None | $2.14 | $2.57 | $5.25 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $4.79 Median $7.08 Typical High $14.13 | Professional | QW · Waived lab test | $4.79 | $7.08 | $14.13 |
CareSource Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
CareSource Setting Professional Modifier None Typical Low $4.57 Median $7.08 Typical High $8.13 | Professional | None | $4.57 | $7.08 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $4.57 Median $7.08 Typical High $23.44 | Facility | None | $4.57 | $7.08 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $10.00 Typical High $19.05 | Professional | None | $4.57 | $10.00 | $19.05 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $14.45 Median $912.01 Typical High $2,187.76 | Facility | None | $14.45 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier QW · Waived lab test Typical Low $4.57 Median $5.62 Typical High $6.46 | Professional | QW · Waived lab test | $4.57 | $5.62 | $6.46 |
United Setting Professional Modifier None Typical Low $2.95 Median $5.37 Typical High $8.51 | Professional | None | $2.95 | $5.37 | $8.51 |
2 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 $2.88 Typical High $13.49 | Professional | 52 · Reduced service | $2.63 | $2.88 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.15 Typical High $5.37 | Professional | 53 · Discontinued | $1.05 | $1.15 | $5.37 |
Where Indiana sits
The same service costs 9.3 times more in Vermont 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· 49th 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.