How much rates vary
Facilitymedian $166 · 10th to 90th $110 to $355Professionalmedian $100 · 10th to 90th $62 to $162
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 $100.00 Median $100.00 Typical High $107.15 | Facility | None | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | None | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | 52 · Reduced service | $50.12 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | 53 · Discontinued | $19.95 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $16.22 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $177.83 | Facility | None | $165.96 | $165.96 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $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 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $199.53 | Professional | None | $141.25 | $165.96 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $151.36 | Professional | None | $109.65 | $109.65 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $239.88 | Facility | None | $181.97 | $181.97 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | None | $89.13 | $89.13 | $100.00 |
Sentara Setting Facility Modifier None Typical Low $109.65 Median $186.21 Typical High $10,232.93 | Facility | None | $109.65 | $186.21 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $158.49 | Professional | None | $93.33 | $114.82 | $158.49 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Facility | None | $169.82 | $169.82 | $204.17 |
United Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $93.33 | Professional | None | $74.13 | $81.28 | $93.33 |
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 Virginia 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.
Virginia· 28th of 51
$100
MN $151UT $61.66
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.