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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $190.55 | Professional | None | $114.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $57.54 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $22.91 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $28.18 Typical High $28.84 | Professional | 55 · Aftercare only | $17.38 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.48 | $19.05 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $309.03 | Facility | None | $223.87 | $229.09 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $295.12 | Professional | None | $109.65 | $109.65 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $177.83 | Professional | None | $107.15 | $107.15 | $177.83 |
Hometown Health Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $239.88 | Professional | None | $181.97 | $223.87 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $4,265.80 | Facility | None | $223.87 | $223.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $251.19 | Professional | None | $154.88 | $208.93 | $251.19 |
United Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $204.17 | Professional | None | $102.33 | $134.90 | $204.17 |
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 Nevada 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.
Nevada· 17th of 51
$191
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.