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 $3.72 Median $5.01 Typical High $12.88 | Facility | None | $3.72 | $5.01 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $4.17 Typical High $12.88 | Professional | None | $3.39 | $4.17 | $12.88 |
Ambetter Setting Professional Modifier None Typical Low $2.24 Median $3.02 Typical High $3.16 | Professional | None | $2.24 | $3.02 | $3.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $4.47 Typical High $13.49 | Facility | None | $3.55 | $4.47 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.24 Typical High $3.47 | Professional | None | $2.14 | $2.24 | $3.47 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $3.09 Median $4.47 Typical High $9.12 | Professional | QW · Waived lab test | $3.09 | $4.47 | $9.12 |
CareSource Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
CareSource Setting Professional Modifier None Typical Low $2.95 Median $4.47 Typical High $5.25 | Professional | None | $2.95 | $4.47 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $4.47 Typical High $15.14 | Facility | None | $2.95 | $4.47 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $5.62 Typical High $12.30 | Professional | None | $2.95 | $5.62 | $12.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $9.33 Median $912.01 Typical High $2,187.76 | Facility | None | $9.33 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier QW · Waived lab test Typical Low $2.95 Median $3.63 Typical High $3.98 | Professional | QW · Waived lab test | $2.95 | $3.63 | $3.98 |
United Setting Professional Modifier None Typical Low $1.91 Median $3.72 Typical High $5.50 | Professional | None | $1.91 | $3.72 | $5.50 |
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 $1.70 Median $1.86 Typical High $10.00 | Professional | 52 · Reduced service | $1.70 | $1.86 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.74 Typical High $3.98 | Professional | 53 · Discontinued | $0.68 | $0.74 | $3.98 |
Where Indiana sits
The same service costs 15.8 times more in Vermont than in Maryland. 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
$3.63
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.