How much rates vary
Facilitymedian $178 · 10th to 90th $117 to $389Professionalmedian $110 · 10th to 90th $65 to $174
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 $109.65 Median $109.65 Typical High $114.82 | Facility | None | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $114.82 | Professional | None | $107.15 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | 52 · Reduced service | $54.95 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $22.91 | Professional | 53 · Discontinued | $21.88 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $17.38 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $11.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Facility | None | $177.83 | $177.83 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $213.80 | Professional | None | $151.36 | $177.83 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $165.96 | Professional | None | $117.49 | $117.49 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Facility | None | $194.98 | $194.98 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $100.00 | Professional | None | $91.20 | $95.50 | $100.00 |
Sentara Setting Facility Modifier None Typical Low $117.49 Median $204.17 Typical High $10,232.93 | Facility | None | $117.49 | $204.17 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $169.82 | Professional | None | $102.33 | $123.03 | $169.82 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $218.78 | Facility | None | $181.97 | $181.97 | $218.78 |
United Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | None | $79.43 | $87.10 | $100.00 |
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 Virginia 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.
Virginia· 26th of 51
$110
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.