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 $81.28 Median $81.28 Typical High $208.93 | Facility | None | $81.28 | $81.28 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | None | $81.28 | $81.28 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $123.03 Typical High $190.55 | Facility | None | $104.71 | $123.03 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $58.88 | Professional | None | $47.86 | $47.86 | $58.88 |
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 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | None | $125.89 | $125.89 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $39.81 Typical High $45.71 | Professional | None | $28.84 | $39.81 | $45.71 |
SummaCare Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $114.82 | Professional | None | $95.50 | $112.20 | $114.82 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $158.49 | Facility | None | $112.20 | $112.20 | $158.49 |
United Setting Professional Modifier None Typical Low $32.36 Median $54.95 Typical High $63.10 | Professional | None | $32.36 | $54.95 | $63.10 |
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 $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $40.74 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | 53 · Discontinued | $16.22 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $13.80 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $9.33 |
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 Ohio 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.
Ohio· 50th of 51
$47.86
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.