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 $109.65 Median $109.65 Typical High $245.47 | Facility | None | $109.65 | $109.65 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $117.49 | Professional | None | $109.65 | $109.65 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $162.18 Typical High $257.04 | Facility | None | $141.25 | $162.18 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $77.62 | Professional | None | $63.10 | $63.10 | $77.62 |
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 |
Aultcare Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | None | $162.18 | $162.18 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $70.79 Typical High $91.20 | Professional | None | $56.23 | $70.79 | $91.20 |
SummaCare Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | None | $125.89 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $204.17 | Facility | None | $144.54 | $144.54 | $204.17 |
United Setting Professional Modifier None Typical Low $41.69 Median $72.44 Typical High $83.18 | Professional | None | $41.69 | $72.44 | $83.18 |
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 $54.95 Median $54.95 Typical High $58.88 | Professional | 52 · Reduced service | $54.95 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $23.44 | Professional | 53 · Discontinued | $21.88 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $17.78 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $11.75 |
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 Ohio 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.
Ohio· 49th of 51
$63.10
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.