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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $123.03 | Professional | None | $75.86 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $38.02 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $24.55 Typical High $25.12 | Professional | 53 · Discontinued | $15.14 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $11.22 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.59 | $12.30 | $12.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $204.17 | Facility | None | $144.54 | $147.91 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $154.88 | Professional | None | $70.79 | $70.79 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $112.20 | Professional | None | $64.57 | $64.57 | $112.20 |
Hometown Health Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $154.88 | Professional | None | $117.49 | $144.54 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $4,265.80 | Facility | None | $144.54 | $144.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $158.49 | Professional | None | $102.33 | $134.90 | $158.49 |
United Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $131.83 | Professional | None | $63.10 | $81.28 | $131.83 |
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 2.4 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.
Nevada· 13th of 51
$123
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.