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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | None | $102.33 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $51.29 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $20.42 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $15.14 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.23 | $15.49 | $15.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $389.05 Typical High $398.11 | Facility | None | $354.81 | $389.05 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $194.98 | Professional | None | $67.61 | $114.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Denver HMP Setting Facility Modifier None Typical Low $125.89 Median $154.88 Typical High $218.78 | Facility | None | $125.89 | $154.88 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | None | $186.21 | $186.21 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $338.84 Typical High $389.05 | Facility | None | $186.21 | $338.84 | $389.05 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $251.19 | Professional | None | $162.18 | $162.18 | $251.19 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
United Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $107.15 | Professional | None | $67.61 | $74.13 | $107.15 |
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 Colorado sits
The same service costs 2.6 times more in Montana than in Ohio. 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.
Colorado· 30th of 51
$112
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.