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 $51.29 Median $51.29 Typical High $70.79 | Facility | None | $51.29 | $51.29 | $70.79 |
Aetna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $77.62 | Professional | None (both parts) | $51.29 | $51.29 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $102.33 Typical High $154.88 | Facility | None | $51.29 | $102.33 | $154.88 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $20.42 Median $20.42 Typical High $28.84 | Professional | None (both parts) | $20.42 | $20.42 | $28.84 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $51.29 Median $56.23 Typical High $102.33 | Professional | QW · Waived lab test | $51.29 | $56.23 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $77.62 Typical High $102.33 | Facility | None | $66.07 | $77.62 | $102.33 |
CareSource Setting Professional Modifier None (both parts) Typical Low $51.29 Median $56.23 Typical High $72.44 | Professional | None (both parts) | $51.29 | $56.23 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $97.72 Typical High $144.54 | Facility | None | $33.11 | $97.72 | $144.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $53.70 Median $67.61 Typical High $67.61 | Professional | None (both parts) | $53.70 | $67.61 | $67.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $87.10 Median $912.01 Typical High $2,187.76 | Facility | None | $87.10 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None (both parts) Typical Low $43.65 Median $51.29 Typical High $51.29 | Professional | None (both parts) | $43.65 | $51.29 | $51.29 |
United Setting Professional Modifier None (both parts) Typical Low $21.38 Median $30.90 Typical High $61.66 | Professional | None (both parts) | $21.38 | $30.90 | $61.66 |
3 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 $25.70 Median $25.70 Typical High $38.90 | Professional | 52 · Reduced service | $25.70 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $15.49 | Professional | 53 · Discontinued | $10.23 | $10.23 | $15.49 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 26 · Professional part | $5.01 | $5.01 | $5.01 |
Where Indiana sits
The same service costs 3.1 times more in Alaska than in Maine. 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
$33.11
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.