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 $104.71 Median $104.71 Typical High $141.25 | Facility | None | $104.71 | $104.71 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $141.25 | Professional | None | $104.71 | $107.15 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $691.83 | Facility | None | $151.36 | $151.36 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $120.23 | Professional | None | $63.10 | $63.10 | $120.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | None | $81.28 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $295.12 Typical High $1,000.00 | Facility | None | $109.65 | $295.12 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $794.33 | Professional | None | $52.48 | $74.13 | $794.33 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $104.71 | Professional | None | $52.48 | $67.61 | $104.71 |
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 $52.48 Median $53.70 Typical High $69.18 | Professional | 52 · Reduced service | $52.48 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $28.18 | Professional | 53 · Discontinued | $20.89 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $20.89 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $14.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $56.23 Median $83.18 Typical High $125.89 | Professional | UE · Used equipment | $56.23 | $83.18 | $125.89 |
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 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.
Missouri· 43rd of 51
$70.79
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.