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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $218.78 | Professional | None | $190.55 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $416.87 | Professional | None | $302.00 | $338.84 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $288.40 | Professional | None | $173.78 | $257.04 | $288.40 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $295.12 Typical High $616.60 | Facility | None | $257.04 | $295.12 | $616.60 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $1,380.38 | Professional | None | $109.65 | $128.82 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $512.86 Typical High $512.86 | Professional | None | $223.87 | $512.86 | $512.86 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $562.34 | Professional | None | $288.40 | $416.87 | $562.34 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $691.83 | Facility | None | $354.81 | $354.81 | $691.83 |
United Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $144.54 | Professional | None | $109.65 | $128.82 | $144.54 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $95.50 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $21.88 |
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 Iowa sits
The same service costs 2.8 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.
Iowa· 6th of 51
$209
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.