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 $6.17 Median $8.32 Typical High $20.89 | Facility | None | $6.17 | $8.32 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $6.31 Typical High $24.55 | Professional | None | $5.62 | $6.31 | $24.55 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $5.62 Typical High $5.62 | Professional | None | $5.13 | $5.62 | $5.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.89 Median $7.59 Typical High $22.39 | Facility | None | $5.89 | $7.59 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.72 Typical High $5.75 | Professional | None | $3.55 | $3.72 | $5.75 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $5.25 Median $7.59 Typical High $15.14 | Professional | QW · Waived lab test | $5.25 | $7.59 | $15.14 |
CareSource Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
CareSource Setting Professional Modifier None Typical Low $4.90 Median $7.59 Typical High $8.71 | Professional | None | $4.90 | $7.59 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $4.90 Median $7.59 Typical High $25.12 | Facility | None | $4.90 | $7.59 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $8.71 Typical High $20.42 | Professional | None | $5.50 | $8.71 | $20.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $15.49 Median $912.01 Typical High $2,187.76 | Facility | None | $15.49 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier QW · Waived lab test Typical Low $4.90 Median $6.03 Typical High $7.24 | Professional | QW · Waived lab test | $4.90 | $6.03 | $7.24 |
United Setting Professional Modifier None Typical Low $3.16 Median $5.89 Typical High $9.12 | Professional | None | $3.16 | $5.89 | $9.12 |
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 $2.82 Median $3.09 Typical High $23.44 | Professional | 52 · Reduced service | $2.82 | $3.09 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.23 Typical High $9.33 | Professional | 53 · Discontinued | $1.12 | $1.23 | $9.33 |
Where Indiana sits
The same service costs 21.4 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· 50th of 51
$5.89
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.