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 $67.61 Median $117.49 Typical High $120.23 | Facility | None | $67.61 | $117.49 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $120.23 | Professional | None | $67.61 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $58.88 Typical High $60.26 | Professional | 52 · Reduced service | $33.88 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $13.49 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $10.00 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.76 | $11.75 | $12.02 |
AvMed Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
AvMed Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $151.36 | Professional | None | $107.15 | $120.23 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Florida Blue Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $489.78 | Facility | None | $281.84 | $281.84 | $489.78 |
Florida Blue Setting Professional Modifier None Typical Low $33.88 Median $114.82 Typical High $151.36 | Professional | None | $33.88 | $114.82 | $151.36 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $34.67 Median $57.54 Typical High $74.13 | Professional | None | $34.67 | $57.54 | $74.13 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | None | $151.36 | $151.36 | $204.17 |
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 Florida 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.
Florida· 48th of 51
$72.44
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.