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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $117.49 | Professional | None | $93.33 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $56.23 Typical High $58.88 | Professional | 52 · Reduced service | $46.77 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.39 Typical High $23.99 | Professional | 53 · Discontinued | $18.62 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.60 Typical High $17.78 | Professional | 55 · Aftercare only | $14.13 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.22 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.33 | $11.22 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $151.36 | Facility | None | $117.49 | $151.36 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | None | $63.10 | $63.10 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $181.97 Typical High $186.21 | Facility | None | $117.49 | $181.97 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $223.87 Median $478.63 Typical High $2,187.76 | Facility | None | $223.87 | $478.63 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $165.96 | Professional | None | $97.72 | $141.25 | $165.96 |
United Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $89.13 | Professional | None | $41.69 | $67.61 | $89.13 |
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 Minnesota 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· 48th of 51
$63.10
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.