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 $81.28 Median $144.54 Typical High $151.36 | Facility | None | $81.28 | $144.54 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $223.87 | Professional | None | $144.54 | $151.36 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $151.36 | Professional | None | $107.15 | $147.91 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $218.78 Typical High $309.03 | Facility | None | $194.98 | $218.78 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $371.54 | Professional | None | $223.87 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $1,288.25 | Professional | None | $109.65 | $158.49 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $147.91 | Professional | None | $44.67 | $44.67 | $147.91 |
United Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $186.21 | Professional | None | $83.18 | $112.20 | $186.21 |
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 $72.44 Median $75.86 Typical High $112.20 | Professional | 52 · Reduced service | $72.44 | $75.86 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $45.71 | Professional | 53 · Discontinued | $28.84 | $30.20 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $33.88 | Professional | 55 · Aftercare only | $21.88 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.45 | $15.14 | $22.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | UE · Used equipment | $81.28 | $81.28 | $81.28 |
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 2.5 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.
Kentucky· 38th of 51
$148
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.