How much rates vary
Facilitymedian $355 · 10th to 90th $178 to $617Professionalmedian $115 · 10th to 90th $87 to $178
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 $77.62 Median $138.04 Typical High $162.18 | Facility | None | $77.62 | $138.04 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $162.18 | Professional | None | $138.04 | $138.04 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $549.54 | Facility | None | $275.42 | $275.42 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $114.82 | Professional | None | $87.10 | $102.33 | $114.82 |
CDPHP Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $977.24 | Facility | None | $275.42 | $446.68 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | None | $302.00 | $302.00 | $398.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $234.42 | Professional | None | $154.88 | $162.18 | $234.42 |
MVP Health Care Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $354.81 | Professional | None | $158.49 | $158.49 | $354.81 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $478.63 | Facility | None | $363.08 | $363.08 | $478.63 |
United Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $177.83 | Professional | None | $102.33 | $147.91 | $177.83 |
Univera Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $275.42 | Facility | None | $165.96 | $275.42 | $275.42 |
Univera Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $275.42 | Professional | None | $154.88 | $162.18 | $275.42 |
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 $69.18 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $32.36 | Professional | 53 · Discontinued | $27.54 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $16.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $223.87 Typical High $275.42 | Professional | UE · Used equipment | $154.88 | $223.87 | $275.42 |
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 New York 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.
New York· 51st of 51
$115
MN $363NY $115
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.