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 $35.48 Median $63.10 Typical High $66.07 | Facility | None | $35.48 | $63.10 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $97.72 | Professional | None | $63.10 | $66.07 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $64.57 | Professional | None | $47.86 | $64.57 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $95.50 Typical High $131.83 | Facility | None | $85.11 | $95.50 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $162.18 | Professional | None | $97.72 | $117.49 | $162.18 |
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 $67.61 Typical High $575.44 | Professional | None | $47.86 | $67.61 | $575.44 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $58.88 | Professional | None | $44.67 | $44.67 | $58.88 |
United Setting Professional Modifier None Typical Low $36.31 Median $48.98 Typical High $79.43 | Professional | None | $36.31 | $48.98 | $79.43 |
8 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 $30.90 Median $33.11 Typical High $48.98 | Professional | 52 · Reduced service | $30.90 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.18 Typical High $19.50 | Professional | 53 · Discontinued | $12.59 | $13.18 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $14.79 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.61 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.31 | $6.61 | $9.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | UE · Used equipment | $35.48 | $35.48 | $35.48 |
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 Kentucky 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.
Kentucky· 37th of 51
$64.57
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.