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 $141.25 Median $141.25 Typical High $190.55 | Facility | None | $141.25 | $141.25 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $190.55 | Professional | None | $120.23 | $141.25 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $933.25 | Facility | None | $204.17 | $204.17 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $162.18 | Professional | None | $67.61 | $67.61 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | None | $109.65 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $316.23 Typical High $1,000.00 | Facility | None | $147.91 | $316.23 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $954.99 | Professional | None | $61.66 | $95.50 | $954.99 |
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 $61.66 Median $91.20 Typical High $141.25 | Professional | None | $61.66 | $91.20 | $141.25 |
8 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 $60.26 Median $70.79 Typical High $93.33 | Professional | 52 · Reduced service | $60.26 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $28.18 Typical High $38.02 | Professional | 53 · Discontinued | $23.99 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.38 Typical High $28.18 | Professional | 55 · Aftercare only | $18.20 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.13 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $14.13 | $19.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $112.20 Typical High $151.36 | Professional | UE · Used equipment | $75.86 | $112.20 | $151.36 |
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 Missouri 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.
Missouri· 40th of 51
$95.50
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.