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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $186.21 | Professional | None | $147.91 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $74.13 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $29.51 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $27.54 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.79 | $16.22 | $18.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $218.78 Typical High $218.78 | Facility | None | $169.82 | $218.78 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $141.25 | Professional | None | $91.20 | $91.20 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $309.03 Typical High $316.23 | Facility | None | $199.53 | $309.03 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $691.83 Typical High $2,187.76 | Facility | None | $323.59 | $691.83 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $245.47 | Professional | None | $141.25 | $213.80 | $245.47 |
United Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $131.83 | Professional | None | $70.79 | $100.00 | $131.83 |
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 3.3 times more in Alaska 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
$105
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.