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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $223.87 | Professional | None | $173.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $109.65 Typical High $112.20 | Professional | 52 · Reduced service | $87.10 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $34.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.11 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.88 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $21.88 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $295.12 Typical High $295.12 | Facility | None | $234.42 | $295.12 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $158.49 | Professional | None | $125.89 | $125.89 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $316.23 Typical High $323.59 | Facility | None | $204.17 | $316.23 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $446.68 Median $912.01 Typical High $2,187.76 | Facility | None | $446.68 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $331.13 | Professional | None | $190.55 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $72.44 Median $134.90 Typical High $177.83 | Professional | None | $72.44 | $134.90 | $177.83 |
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 2.8 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· 42nd of 51
$126
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.