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 $47.86 Median $85.11 Typical High $89.13 | Facility | None | $47.86 | $85.11 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $131.83 | Professional | None | $85.11 | $89.13 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $89.13 | Professional | None | $63.10 | $87.10 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $128.82 Typical High $181.97 | Facility | None | $114.82 | $128.82 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $218.78 | Professional | None | $131.83 | $158.49 | $218.78 |
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 $93.33 Typical High $776.25 | Professional | None | $64.57 | $93.33 | $776.25 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $83.18 | Professional | None | $44.67 | $44.67 | $83.18 |
United Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $109.65 | Professional | None | $48.98 | $66.07 | $109.65 |
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 $42.66 Median $44.67 Typical High $66.07 | Professional | 52 · Reduced service | $42.66 | $44.67 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.78 Typical High $26.92 | Professional | 53 · Discontinued | $16.98 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $19.95 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.91 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.51 | $8.91 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | UE · Used equipment | $47.86 | $47.86 | $47.86 |
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 Kentucky 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.
Kentucky· 37th of 51
$87.10
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.