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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $204.17 | Professional | None | $169.82 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $85.11 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.02 Typical High $40.74 | Professional | 53 · Discontinued | $33.88 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.84 Typical High $30.20 | Professional | 55 · Aftercare only | $25.70 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.05 Typical High $20.42 | Professional | 56 · Pre-op care only | $16.98 | $19.05 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $257.04 Typical High $257.04 | Facility | None | $204.17 | $257.04 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $151.36 | Professional | None | $107.15 | $107.15 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $338.84 | Facility | None | $208.93 | $331.13 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $380.19 Median $812.83 Typical High $2,187.76 | Facility | None | $380.19 | $812.83 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $288.40 | Professional | None | $165.96 | $251.19 | $288.40 |
United Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $154.88 | Professional | None | $75.86 | $114.82 | $154.88 |
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 2.5 times more in Alaska than in Utah. 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
$110
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.