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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $245.47 | Professional | None | $144.54 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $72.44 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $28.84 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $21.88 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.45 | $24.55 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $407.38 | Facility | None | $288.40 | $295.12 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $288.40 | Professional | None | $141.25 | $141.25 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $173.78 | Professional | None | $104.71 | $104.71 | $173.78 |
Hometown Health Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $309.03 | Professional | None | $234.42 | $288.40 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $4,265.80 | Facility | None | $288.40 | $288.40 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $288.40 | Professional | None | $204.17 | $223.87 | $288.40 |
United Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $263.03 | Professional | None | $100.00 | $131.83 | $263.03 |
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 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.
Nevada· 3rd of 51
$245
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.