How much rates vary
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 $199.53 Median $199.53 Typical High $263.03 | Facility | None | $199.53 | $199.53 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $263.03 | Professional | None | $190.55 | $204.17 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $1,288.25 | Facility | None | $281.84 | $281.84 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $223.87 | Professional | None | $107.15 | $107.15 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | None | $154.88 | $169.82 | $169.82 |
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 $512.86 Typical High $1,230.27 | Facility | None | $204.17 | $512.86 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $1,479.11 | Professional | None | $93.33 | $138.04 | $1,479.11 |
United Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
United Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $194.98 | Professional | None | $93.33 | $128.82 | $194.98 |
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 $93.33 Median $102.33 Typical High $131.83 | Professional | 52 · Reduced service | $93.33 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $52.48 | Professional | 53 · Discontinued | $38.02 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $28.18 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $26.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $104.71 Median $154.88 Typical High $229.09 | Professional | UE · Used equipment | $104.71 | $154.88 | $229.09 |
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 Missouri 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.
Missouri· 42nd of 51
$135
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.