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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $158.49 | Professional | None | $95.50 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $77.62 Typical High $79.43 | Professional | 52 · Reduced service | $47.86 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $19.05 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $23.44 Typical High $23.99 | Professional | 55 · Aftercare only | $14.45 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.55 | $15.85 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $190.55 Typical High $257.04 | Facility | None | $186.21 | $190.55 | $257.04 |
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 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $134.90 | Professional | None | $89.13 | $89.13 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $199.53 | Professional | None | $151.36 | $186.21 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $4,265.80 | Facility | None | $186.21 | $186.21 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $190.55 | Professional | None | $128.82 | $173.78 | $190.55 |
United Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $169.82 | Professional | None | $85.11 | $112.20 | $169.82 |
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 2.6 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· 13th of 51
$158
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.