How much rates vary
Facilitymedian $204 · 10th to 90th $132 to $457Professionalmedian $81 · 10th to 90th $65 to $132
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 $57.54 Median $102.33 Typical High $120.23 | Facility | None | $57.54 | $102.33 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | None | $102.33 | $102.33 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $407.38 | Facility | None | $204.17 | $204.17 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $85.11 | Professional | None | $64.57 | $75.86 | $85.11 |
CDPHP Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 |
Emblem Health Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $724.44 | Facility | None | $204.17 | $331.13 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $295.12 | Professional | None | $223.87 | $223.87 | $295.12 |
Excellus BCBS Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $169.82 | Professional | None | $112.20 | $120.23 | $169.82 |
MVP Health Care Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $199.53 | Professional | None | $117.49 | $117.49 | $199.53 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $263.03 | Facility | None | $204.17 | $204.17 | $263.03 |
United Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $131.83 | Professional | None | $69.18 | $104.71 | $131.83 |
Univera Setting Facility Modifier None Typical Low $123.03 Median $204.17 Typical High $204.17 | Facility | None | $123.03 | $204.17 | $204.17 |
Univera Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $204.17 | Professional | None | $112.20 | $120.23 | $204.17 |
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 $51.29 Median $51.29 Typical High $60.26 | Professional | 52 · Reduced service | $51.29 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $23.99 | Professional | 53 · Discontinued | $20.42 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $123.03 Typical High $151.36 | Professional | UE · Used equipment | $85.11 | $123.03 | $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 New York 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.
New York· 46th of 51
$81.28
MT $186OH $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.