How much rates vary
Facilitymedian $182 · 10th to 90th $102 to $347Professionalmedian $65 · 10th to 90th $49 to $100
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 $43.65 Median $77.62 Typical High $91.20 | Facility | None | $43.65 | $77.62 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $309.03 | Facility | None | $154.88 | $154.88 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $64.57 | Professional | None | $48.98 | $58.88 | $64.57 |
CDPHP Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 |
Emblem Health Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $562.34 | Facility | None | $154.88 | $257.04 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $223.87 | Professional | None | $169.82 | $169.82 | $223.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $131.83 | Professional | None | $87.10 | $91.20 | $131.83 |
MVP Health Care Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $177.83 | Professional | None | $91.20 | $91.20 | $177.83 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $234.42 | Facility | None | $181.97 | $181.97 | $234.42 |
United Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $100.00 | Professional | None | $58.88 | $81.28 | $100.00 |
Univera Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $154.88 | Facility | None | $95.50 | $154.88 | $154.88 |
Univera Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $154.88 | Professional | None | $87.10 | $91.20 | $154.88 |
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 $38.90 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $15.49 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $109.65 Typical High $134.90 | Professional | UE · Used equipment | $83.18 | $109.65 | $134.90 |
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 2.4 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.
New York· 50th of 51
$64.57
MT $155UT $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.