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 $186.21 Median $186.21 Typical High $245.47 | Facility | None | $186.21 | $186.21 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $245.47 | Professional | None | $181.97 | $190.55 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $1,230.27 | Facility | None | $263.03 | $263.03 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $208.93 | Professional | None | $125.89 | $125.89 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | None | $144.54 | $158.49 | $158.49 |
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 $190.55 Median $575.44 Typical High $1,148.15 | Facility | None | $190.55 | $575.44 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $1,380.38 | Professional | None | $91.20 | $128.82 | $1,380.38 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $181.97 | Professional | None | $91.20 | $120.23 | $181.97 |
8 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 $91.20 Median $95.50 Typical High $123.03 | Professional | 52 · Reduced service | $91.20 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $48.98 | Professional | 53 · Discontinued | $36.31 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $27.54 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $97.72 Median $144.54 Typical High $223.87 | Professional | UE · Used equipment | $97.72 | $144.54 | $223.87 |
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 Missouri 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.
Missouri· 44th of 51
$126
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.