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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $144.54 | Professional | None | $87.10 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $43.65 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $17.78 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $21.38 Typical High $21.88 | Professional | 55 · Aftercare only | $13.18 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.71 | $14.45 | $14.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $234.42 | Facility | None | $169.82 | $173.78 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $204.17 | Professional | None | $83.18 | $83.18 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $134.90 | Professional | None | $72.44 | $72.44 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $181.97 | Professional | None | $138.04 | $169.82 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $4,265.80 | Facility | None | $169.82 | $169.82 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $186.21 | Professional | None | $117.49 | $158.49 | $186.21 |
United Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $154.88 | Professional | None | $69.18 | $89.13 | $154.88 |
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 Nevada 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.
Nevada· 8th of 51
$145
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.