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 $213.80 Median $213.80 Typical High $223.87 | Facility | None | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | None | $213.80 | $213.80 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $954.99 Typical High $1,000.00 | Facility | None | $275.42 | $954.99 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $1,659.59 | Professional | None | $204.17 | $245.47 | $1,659.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.39 Median $36.31 Typical High $165.96 | Professional | RR · Rental | $22.39 | $36.31 | $165.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $275.42 Typical High $1,258.93 | Professional | UE · Used equipment | $165.96 | $275.42 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $275.42 | Professional | None | $218.78 | $275.42 | $275.42 |
Oscar Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $190.55 | Professional | None | $89.13 | $120.23 | $190.55 |
7 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 $107.15 Median $107.15 Typical High $112.20 | Professional | 52 · Reduced service | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | 53 · Discontinued | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $33.11 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $22.39 |
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 Georgia sits
The same service costs 3.2 times more in Minnesota than in New York. 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.
Georgia· 10th of 51
$240
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.