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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $100.00 | Professional | None | $74.13 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $42.66 Typical High $50.12 | Professional | 52 · Reduced service | $37.15 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $16.98 Typical High $20.42 | Professional | 53 · Discontinued | $14.79 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $11.22 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.51 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.41 | $8.51 | $10.00 |
BCBS Kansas Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $223.87 | Facility | None | $75.86 | $95.50 | $223.87 |
Medica Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $645.65 | Professional | None | $45.71 | $50.12 | $645.65 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $131.83 | Facility | None | $112.20 | $112.20 | $131.83 |
United Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | None | $40.74 | $50.12 | $50.12 |
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 Kansas 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.
Kansas· 32nd 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.