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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $89.13 | Professional | None | $67.61 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $33.88 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.98 Typical High $17.78 | Professional | 53 · Discontinued | $13.80 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.59 Typical High $13.49 | Professional | 55 · Aftercare only | $10.23 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.76 | $8.32 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $112.20 Typical High $112.20 | Facility | None | $89.13 | $112.20 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $64.57 | Professional | None | $47.86 | $47.86 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $91.20 Median $141.25 Typical High $147.91 | Facility | None | $91.20 | $141.25 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $169.82 Median $354.81 Typical High $2,187.76 | Facility | None | $169.82 | $354.81 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $125.89 | Professional | None | $72.44 | $109.65 | $125.89 |
United Setting Professional Modifier None Typical Low $32.36 Median $51.29 Typical High $67.61 | Professional | None | $32.36 | $51.29 | $67.61 |
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 |
|---|---|---|---|---|---|
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Indiana sits
The same service costs 2.6 times more in Hawaii 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
$47.86
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.