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 |
|---|---|---|---|---|---|
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $8.91 Median $10.72 Typical High $18.62 | Professional | 51 · Multiple procedures | $8.91 | $10.72 | $18.62 |
HMSA Setting Professional Modifier HM · Below bachelor's level Typical Low $17.78 Median $18.62 Typical High $18.62 | Professional | HM · Below bachelor's level | $17.78 | $18.62 | $18.62 |
HMSA Setting Professional Modifier HN · Bachelor's level Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | HN · Bachelor's level | $20.42 | $21.38 | $21.38 |
Kaiser Permanente Setting Professional Modifier HM · Below bachelor's level Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | HM · Below bachelor's level | $15.14 | $15.14 | $15.14 |
Kaiser Permanente Setting Professional Modifier HN · Bachelor's level Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | HN · Bachelor's level | $19.95 | $19.95 | $19.95 |
University Health Alliance Setting Professional Modifier HM · Below bachelor's level Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | HM · Below bachelor's level | $15.14 | $15.14 | $15.14 |
9 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 None Typical Low $5.25 Median $26.30 Typical High $36.31 | Professional | None | $5.25 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $13.18 Typical High $18.20 | Professional | 52 · Reduced service | $2.63 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $5.37 Typical High $7.24 | Professional | 53 · Discontinued | $1.07 | $5.37 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $3.98 Typical High $5.50 | Professional | 55 · Aftercare only | $0.79 | $3.98 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $2.69 Typical High $3.63 | Professional | 56 · Pre-op care only | $0.52 | $2.69 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $20.42 Typical High $28.84 | Professional | None | $15.85 | $20.42 | $28.84 |
HMSA Setting Professional Modifier None Typical Low $20.42 Median $23.44 Typical High $43.65 | Professional | None | $20.42 | $23.44 | $43.65 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | HO · Master's level | $32.36 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $9.33 Median $23.99 Typical High $23.99 | Professional | None | $9.33 | $23.99 | $23.99 |
Where Hawaii sits
The same service costs 11.7 times more in New York than in North Carolina. 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.
Hawaii· 35th of 51
$23.99
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.