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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $275.42 | Professional | None | $204.17 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $102.33 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $40.74 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $30.90 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.42 | $23.44 | $27.54 |
BCBS Kansas Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $257.04 Typical High $512.86 | Facility | None | $204.17 | $257.04 | $512.86 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $1,479.11 | Professional | None | $112.20 | $138.04 | $1,479.11 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $309.03 | Facility | None | $263.03 | $263.03 | $309.03 |
United Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | None | $93.33 | $138.04 | $138.04 |
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 Kansas sits
The same service costs 2.5 times more in Alaska 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.
Kansas· 17th of 51
$200
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.