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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $245.47 | Professional | None | $218.78 | $229.09 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $512.86 | Professional | None | $309.03 | $416.87 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $426.58 | Professional | None | $229.09 | $295.12 | $426.58 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $354.81 Typical High $741.31 | Facility | None | $295.12 | $354.81 | $741.31 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $1,698.24 | Professional | None | $123.03 | $134.90 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $537.03 Typical High $537.03 | Professional | None | $281.84 | $537.03 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $645.65 | Professional | None | $295.12 | $457.09 | $645.65 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $831.76 | Facility | None | $436.52 | $436.52 | $831.76 |
United Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $151.36 | Professional | None | $123.03 | $134.90 | $151.36 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $109.65 Median $114.82 Typical High $123.03 | Professional | 52 · Reduced service | $109.65 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $45.71 Typical High $48.98 | Professional | 53 · Discontinued | $43.65 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.88 Typical High $37.15 | Professional | 55 · Aftercare only | $32.36 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.91 Typical High $24.55 | Professional | 56 · Pre-op care only | $21.88 | $22.91 | $24.55 |
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 Iowa 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.
Iowa· 23rd of 51
$219
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.