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 $43.65 Median $77.62 Typical High $79.43 | Facility | None | $43.65 | $77.62 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $81.28 | Professional | None | $43.65 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $38.90 Typical High $39.81 | Professional | 52 · Reduced service | $21.88 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $15.49 Typical High $16.22 | Professional | 53 · Discontinued | $8.71 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $11.75 Typical High $12.02 | Professional | 55 · Aftercare only | $6.61 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.76 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.37 | $7.76 | $7.94 |
AvMed Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
AvMed Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $100.00 | Professional | None | $69.18 | $79.43 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Florida Blue Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $316.23 | Facility | None | $186.21 | $186.21 | $316.23 |
Florida Blue Setting Professional Modifier None Typical Low $21.88 Median $75.86 Typical High $100.00 | Professional | None | $21.88 | $75.86 | $100.00 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $34.67 Median $48.98 Typical High $60.26 | Professional | None | $34.67 | $48.98 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | None | $100.00 | $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 Florida 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.
Florida· 42nd of 51
$54.95
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.