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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | None | $169.82 | $169.82 | $213.80 |
Hally Health Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $147.91 | Professional | None | $117.49 | $144.54 | $147.91 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $169.82 Typical High $346.74 | Facility | None | $147.91 | $169.82 | $346.74 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $794.33 | Professional | None | $63.10 | $74.13 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $295.12 | Professional | None | $144.54 | $295.12 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $316.23 | Professional | None | $151.36 | $208.93 | $316.23 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $389.05 | Facility | None | $204.17 | $204.17 | $389.05 |
United Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $79.43 | Professional | None | $63.10 | $74.13 | $79.43 |
Wellmark Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
7 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 $53.70 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $53.70 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $21.38 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.72 | $12.59 | $12.59 |
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 Iowa sits
The same service costs 2.5 times more in Minnesota 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.
Iowa· 8th of 51
$120
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.