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 $190.55 Median $190.55 Typical High $257.04 | Facility | None | $190.55 | $190.55 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $194.98 Typical High $257.04 | Professional | None | $190.55 | $194.98 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $1,258.93 | Facility | None | $275.42 | $275.42 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $218.78 | Professional | None | $154.88 | $154.88 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | None | $147.91 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $602.56 Typical High $1,380.38 | Facility | None | $199.53 | $602.56 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $1,698.24 | Professional | None | $112.20 | $134.90 | $1,698.24 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $190.55 | Professional | None | $112.20 | $123.03 | $190.55 |
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 $95.50 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $95.50 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.90 Typical High $51.29 | Professional | 53 · Discontinued | $38.02 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $29.51 Typical High $38.02 | Professional | 55 · Aftercare only | $28.84 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.05 | $19.50 | $25.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $151.36 Typical High $229.09 | Professional | UE · Used equipment | $117.49 | $151.36 | $229.09 |
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 Missouri 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.
Missouri· 37th of 51
$155
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.