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 $77.62 Median $128.82 Typical High $134.90 | Facility | None | $77.62 | $128.82 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $204.17 | Professional | None | $128.82 | $134.90 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $141.25 | Professional | None | $91.20 | $141.25 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $204.17 Typical High $288.40 | Facility | None | $181.97 | $204.17 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $346.74 | Professional | None | $213.80 | $251.19 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $1,230.27 | Professional | None | $104.71 | $147.91 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $173.78 | Professional | None | $70.79 | $104.71 | $173.78 |
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 $63.10 Median $67.61 Typical High $102.33 | Professional | 52 · Reduced service | $63.10 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $40.74 | Professional | 53 · Discontinued | $25.70 | $26.92 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.42 Typical High $30.20 | Professional | 55 · Aftercare only | $19.05 | $20.42 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | UE · Used equipment | $69.18 | $69.18 | $69.18 |
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 Kentucky sits
The same service costs 3.3 times more in Alaska than in Indiana. 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.
Kentucky· 38th of 51
$141
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.