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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $131.83 | Professional | None | $109.65 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $60.26 Typical High $66.07 | Professional | 52 · Reduced service | $54.95 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.99 Typical High $26.30 | Professional | 53 · Discontinued | $21.88 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.78 Typical High $19.95 | Professional | 55 · Aftercare only | $16.22 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.02 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.96 | $12.02 | $13.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $158.49 | Facility | None | $125.89 | $158.49 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $100.00 | Professional | None | $67.61 | $67.61 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $223.87 | Facility | None | $138.04 | $213.80 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $239.88 Median $501.19 Typical High $2,187.76 | Facility | None | $239.88 | $501.19 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $177.83 | Professional | None | $104.71 | $154.88 | $177.83 |
United Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $95.50 | Professional | None | $48.98 | $74.13 | $95.50 |
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 Montana than in Ohio. 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
$72.44
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.