How much rates vary
Facilitymedian $178 · 10th to 90th $158 to $437Professionalmedian $132 · 10th to 90th $72 to $229
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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | None | $123.03 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $177.83 Typical High $263.03 | Facility | None | $158.49 | $177.83 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | None | $147.91 | $147.91 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $501.19 Typical High $741.31 | Facility | None | $436.52 | $501.19 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $141.25 Typical High $229.09 | Professional | None | $72.44 | $141.25 | $229.09 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $165.96 | Facility | None | $128.82 | $158.49 | $165.96 |
DeanCare Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $208.93 | Professional | None | $169.82 | $177.83 | $208.93 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $239.88 | Facility | None | $128.82 | $158.49 | $239.88 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $954.99 | Professional | None | $70.79 | $93.33 | $954.99 |
Network Health Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $229.09 | Professional | None | $117.49 | $147.91 | $229.09 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $165.96 | Facility | None | $128.82 | $158.49 | $165.96 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $380.19 | Professional | None | $147.91 | $181.97 | $380.19 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $57.54 Median $77.62 Typical High $128.82 | Professional | None | $57.54 | $77.62 | $128.82 |
7 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 $61.66 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $24.55 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.30 | $13.18 | $13.18 |
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 Wisconsin 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.
Wisconsin· 11th of 51
$138
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.