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 $204.17 Median $204.17 Typical High $269.15 | Facility | None | $204.17 | $204.17 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $269.15 | Professional | None | $173.78 | $204.17 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $1,318.26 | Facility | None | $288.40 | $288.40 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $229.09 | Professional | None | $91.20 | $91.20 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | None | $158.49 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $512.86 Typical High $1,174.90 | Facility | None | $208.93 | $512.86 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $1,621.81 | Professional | None | $89.13 | $138.04 | $1,621.81 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $199.53 | Professional | None | $89.13 | $131.83 | $199.53 |
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 $89.13 Median $100.00 Typical High $134.90 | Professional | 52 · Reduced service | $89.13 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $40.74 Typical High $53.70 | Professional | 53 · Discontinued | $35.48 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $40.74 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.78 | $20.42 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $107.15 Median $158.49 Typical High $218.78 | Professional | UE · Used equipment | $107.15 | $158.49 | $218.78 |
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 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.
Missouri· 41st of 51
$138
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.