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 $13.80 Median $20.89 Typical High $63.10 | Facility | None | $13.80 | $20.89 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $13.80 Typical High $28.18 | Professional | None | $12.88 | $13.80 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $16.98 | Professional | None | $11.48 | $11.48 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.49 Median $16.98 Typical High $51.29 | Facility | None | $13.49 | $16.98 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.32 Typical High $13.18 | Professional | None | $8.13 | $8.32 | $13.18 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $11.75 Median $16.98 Typical High $33.88 | Professional | QW · Waived lab test | $11.75 | $16.98 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
CareSource Setting Professional Modifier None Typical Low $10.96 Median $16.98 Typical High $19.50 | Professional | None | $10.96 | $16.98 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $10.96 Median $16.98 Typical High $57.54 | Facility | None | $10.96 | $16.98 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $19.95 Typical High $45.71 | Professional | None | $11.22 | $19.95 | $45.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $24.55 Median $912.01 Typical High $2,187.76 | Facility | None | $24.55 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier QW · Waived lab test Typical Low $11.22 Median $13.80 Typical High $15.85 | Professional | QW · Waived lab test | $11.22 | $13.80 | $15.85 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.23 Typical High $20.42 | Professional | None | $7.08 | $10.23 | $20.42 |
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 $6.46 Median $6.92 Typical High $48.98 | Professional | 52 · Reduced service | $6.46 | $6.92 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.82 Typical High $19.50 | Professional | 53 · Discontinued | $2.51 | $2.82 | $19.50 |
Where Indiana sits
The same service costs 8.1 times more in Vermont than in Indiana. 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· 51st of 51
$12.88
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.