How much rates vary
Facilitymedian $132 · 10th to 90th $87 to $288Professionalmedian $81 · 10th to 90th $48 to $126
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 $85.11 | Facility | None | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | None | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $39.81 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.98 | Professional | 53 · Discontinued | $16.22 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.88 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $141.25 | Facility | None | $131.83 | $131.83 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $158.49 | Professional | None | $112.20 | $131.83 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | None | $87.10 | $87.10 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $190.55 | Facility | None | $144.54 | $144.54 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | None | $70.79 | $70.79 | $77.62 |
Sentara Setting Facility Modifier None Typical Low $87.10 Median $147.91 Typical High $10,232.93 | Facility | None | $87.10 | $147.91 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $125.89 | Professional | None | $75.86 | $91.20 | $125.89 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Facility | None | $131.83 | $131.83 | $158.49 |
United Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $74.13 | Professional | None | $58.88 | $64.57 | $74.13 |
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 Virginia 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.
Virginia· 26th of 51
$81.28
HI $126IN $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.