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 $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 $257.04 | Professional | None | $190.55 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $95.50 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $38.02 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $32.36 Typical High $38.90 | Professional | 55 · Aftercare only | $28.84 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $25.70 |
BCBS Kansas Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $245.47 Typical High $588.84 | Facility | None | $177.83 | $245.47 | $588.84 |
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 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $295.12 | Facility | None | $251.19 | $251.19 | $295.12 |
United Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $128.82 | Professional | None | $91.20 | $128.82 | $128.82 |
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 Kansas 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.
Kansas· 18th of 51
$186
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.