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 $45.71 Median $79.43 Typical High $87.10 | Facility | None | $45.71 | $79.43 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $125.89 | Professional | None | $79.43 | $87.10 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $83.18 | Professional | None | $63.10 | $83.18 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $120.23 Typical High $169.82 | Facility | None | $107.15 | $120.23 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $204.17 | Professional | None | $125.89 | $147.91 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $724.44 | Professional | None | $61.66 | $87.10 | $724.44 |
United Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $102.33 | Professional | None | $48.98 | $63.10 | $102.33 |
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 $39.81 Median $43.65 Typical High $63.10 | Professional | 52 · Reduced service | $39.81 | $43.65 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $25.12 | Professional | 53 · Discontinued | $15.85 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.18 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $13.18 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.71 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.94 | $8.71 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | UE · Used equipment | $46.77 | $46.77 | $46.77 |
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 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.
Kentucky· 39th of 51
$83.18
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.