How much rates vary
Facilitymedian $263 · 10th to 90th $170 to $562Professionalmedian $158 · 10th to 90th $107 to $282
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 $158.49 Median $158.49 Typical High $169.82 | Facility | None | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $169.82 | Professional | None | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | 52 · Reduced service | $79.43 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | 53 · Discontinued | $31.62 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $25.12 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $275.42 | Facility | None | $263.03 | $263.03 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $316.23 | Professional | None | $223.87 | $263.03 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $239.88 | Professional | None | $169.82 | $169.82 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $380.19 | Facility | None | $288.40 | $288.40 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $173.78 | Professional | None | $141.25 | $141.25 | $173.78 |
Sentara Setting Facility Modifier None Typical Low $169.82 Median $295.12 Typical High $10,232.93 | Facility | None | $169.82 | $295.12 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $251.19 | Professional | None | $147.91 | $181.97 | $251.19 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Facility | None | $295.12 | $295.12 | $354.81 |
United Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $144.54 | Professional | None | $114.82 | $128.82 | $144.54 |
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 2.8 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.
Virginia· 29th of 51
$158
MN $295UT $107
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.