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 Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $104.71 | Professional | None | $61.66 | $74.13 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
HMSA Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $97.72 | Professional | None | $79.43 | $91.20 | $97.72 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $45.71 Typical High $48.98 | Professional | 51 · Multiple procedures | $39.81 | $45.71 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $93.33 | Professional | None | $63.10 | $74.13 | $93.33 |
United Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
University Health Alliance Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $87.10 | Professional | None | $64.57 | $87.10 | $87.10 |
4 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 $30.90 Median $35.48 Typical High $45.71 | Professional | 52 · Reduced service | $30.90 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.13 Typical High $18.20 | Professional | 53 · Discontinued | $12.30 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.72 Typical High $13.80 | Professional | 55 · Aftercare only | $9.33 | $10.72 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.08 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.17 | $7.08 | $9.12 |
Where Hawaii sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 21st of 51
$87.10
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.