How much rates vary
Facilitymedian $309 · 10th to 90th $204 to $676Professionalmedian $191 · 10th to 90th $132 to $347
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 $199.53 | Facility | None | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 52 · Reduced service | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 53 · Discontinued | $38.02 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $30.20 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.95 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $331.13 | Facility | None | $309.03 | $309.03 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $371.54 | Professional | None | $263.03 | $309.03 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $288.40 | Professional | None | $204.17 | $204.17 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $457.09 | Facility | None | $338.84 | $338.84 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $199.53 | Professional | None | $158.49 | $165.96 | $199.53 |
Sentara Setting Facility Modifier None Typical Low $204.17 Median $354.81 Typical High $10,232.93 | Facility | None | $204.17 | $354.81 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $302.00 | Professional | None | $177.83 | $213.80 | $302.00 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $436.52 | Facility | None | $363.08 | $363.08 | $436.52 |
United Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $173.78 | Professional | None | $138.04 | $151.36 | $173.78 |
3 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 |
|---|---|---|---|---|---|
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 Virginia 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.
Virginia· 32nd of 51
$191
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.