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 $97.72 Median $169.82 Typical High $213.80 | Facility | None | $97.72 | $169.82 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $269.15 | Professional | None | $169.82 | $213.80 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $177.83 | Professional | None | $154.88 | $177.83 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $363.08 | Facility | None | $229.09 | $257.04 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $446.68 | Professional | None | $269.15 | $316.23 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $1,445.44 | Professional | None | $131.83 | $186.21 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $147.91 | Professional | None | $44.67 | $44.67 | $147.91 |
United Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $218.78 | Professional | None | $104.71 | $134.90 | $218.78 |
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 $85.11 Median $107.15 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $25.70 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | UE · Used equipment | $114.82 | $114.82 | $114.82 |
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 Kentucky 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.
Kentucky· 34th of 51
$178
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.