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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $112.20 | Professional | None | $93.33 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $52.48 Typical High $56.23 | Professional | 52 · Reduced service | $46.77 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $20.89 Typical High $22.39 | Professional | 53 · Discontinued | $18.62 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.49 Typical High $16.60 | Professional | 55 · Aftercare only | $14.13 | $15.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.47 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.33 | $10.47 | $11.22 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,288.25 | Professional | None | $812.83 | $812.83 | $1,288.25 |
United Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $63.10 | Professional | None | $41.69 | $56.23 | $63.10 |
3 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 |
|---|---|---|---|---|---|
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 Tennessee 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.
Tennessee· 23rd of 51
$105
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.