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 $263.03 Median $263.03 Typical High $891.25 | Facility | None | $263.03 | $263.03 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $269.15 | Professional | None | $229.09 | $263.03 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $338.84 Median $389.05 Typical High $616.60 | Facility | None | $338.84 | $389.05 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | None | $154.88 | $154.88 | $177.83 |
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 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | None | $346.74 | $346.74 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $169.82 | Professional | None | $109.65 | $147.91 | $169.82 |
SummaCare Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $371.54 | Professional | None | $309.03 | $363.08 | $371.54 |
United Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $436.52 | Facility | None | $309.03 | $309.03 | $436.52 |
United Setting Professional Modifier None Typical Low $89.13 Median $173.78 Typical High $204.17 | Professional | None | $89.13 | $173.78 | $204.17 |
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 $114.82 Median $131.83 Typical High $134.90 | Professional | 52 · Reduced service | $114.82 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $53.70 | Professional | 53 · Discontinued | $45.71 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $33.88 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $26.92 |
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 Ohio 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.
Ohio· 38th 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.