How much rates vary
Facilitymedian $123 · 10th to 90th $93 to $309Professionalmedian $93 · 10th to 90th $48 to $158
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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $123.03 Typical High $186.21 | Facility | None | $112.20 | $123.03 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | None | $104.71 | $104.71 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $346.74 Typical High $524.81 | Facility | None | $309.03 | $346.74 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $93.33 Typical High $158.49 | Professional | None | $47.86 | $93.33 | $158.49 |
DeanCare Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $114.82 | Facility | None | $85.11 | $109.65 | $114.82 |
DeanCare Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $177.83 | Professional | None | $120.23 | $177.83 | $177.83 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $154.88 | Facility | None | $85.11 | $109.65 | $154.88 |
Medica Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $645.65 | Professional | None | $48.98 | $54.95 | $645.65 |
Network Health Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $158.49 | Professional | None | $83.18 | $104.71 | $158.49 |
Prevea360 Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $114.82 | Facility | None | $85.11 | $109.65 | $114.82 |
Quartz Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $245.47 | Professional | None | $97.72 | $123.03 | $245.47 |
Quartz Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
The Alliance Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $245.47 | Professional | None | $125.89 | $144.54 | $245.47 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $87.10 | Professional | None | $38.02 | $52.48 | $87.10 |
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 $42.66 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $42.66 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $16.98 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.88 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $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 Wisconsin 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.
Wisconsin· 11th of 51
$93.33
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.