How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $89.13 | Professional | None | $67.61 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $43.65 Typical High $44.67 | Professional | 52 · Reduced service | $33.11 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $17.38 Typical High $17.78 | Professional | 53 · Discontinued | $13.49 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.18 Typical High $13.49 | Professional | 55 · Aftercare only | $10.00 | $13.18 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.76 | $8.71 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $223.87 Typical High $223.87 | Facility | None | $204.17 | $223.87 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $125.89 | Professional | None | $45.71 | $74.13 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Denver HMP Setting Facility Modifier None Typical Low $79.43 Median $89.13 Typical High $125.89 | Facility | None | $79.43 | $89.13 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $173.78 | Professional | None | $104.71 | $104.71 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $194.98 Typical High $218.78 | Facility | None | $104.71 | $194.98 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $141.25 | Professional | None | $93.33 | $93.33 | $141.25 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $69.18 | Professional | None | $43.65 | $48.98 | $69.18 |
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 Colorado sits
The same service costs 2.6 times more in Hawaii 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.
Colorado· 31st of 51
$74.13
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.