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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | None | $81.28 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $158.49 | Professional | None | $117.49 | $128.82 | $158.49 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $117.49 | Professional | None | $85.11 | $100.00 | $117.49 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $128.82 Typical High $275.42 | Facility | None | $112.20 | $128.82 | $275.42 |
Medica Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $645.65 | Professional | None | $46.77 | $50.12 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $199.53 | Professional | None | $102.33 | $199.53 | $199.53 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $218.78 | Professional | None | $112.20 | $158.49 | $218.78 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $309.03 | Facility | None | $158.49 | $158.49 | $309.03 |
United Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $54.95 | Professional | None | $46.77 | $50.12 | $54.95 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
7 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $40.74 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.22 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.30 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.13 | $8.51 | $8.51 |
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 Iowa 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.
Iowa· 21st of 51
$83.18
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.