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 $60.26 Median $107.15 Typical High $107.15 | Facility | None | $60.26 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $109.65 | Professional | None | $60.26 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $52.48 Typical High $54.95 | Professional | 52 · Reduced service | $30.20 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $12.02 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $15.85 Typical High $16.22 | Professional | 55 · Aftercare only | $8.91 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $10.72 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.03 | $10.72 | $10.96 |
AvMed Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
AvMed Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $134.90 | Professional | None | $95.50 | $109.65 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Florida Blue Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $436.52 | Facility | None | $251.19 | $251.19 | $436.52 |
Florida Blue Setting Professional Modifier None Typical Low $30.20 Median $102.33 Typical High $134.90 | Professional | None | $30.20 | $102.33 | $134.90 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
United Setting Professional Modifier None Typical Low $34.67 Median $54.95 Typical High $66.07 | Professional | None | $34.67 | $54.95 | $66.07 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | None | $134.90 | $134.90 | $181.97 |
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 2.4 times more in Montana than in Utah. 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· 49th of 51
$64.57
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.