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 $107.15 Median $128.82 Typical High $269.15 | Professional | None | $107.15 | $128.82 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
HMSA Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $165.96 | Professional | None | $131.83 | $151.36 | $165.96 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $75.86 Typical High $81.28 | Professional | 51 · Multiple procedures | $66.07 | $75.86 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $158.49 | Professional | None | $109.65 | $128.82 | $158.49 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
University Health Alliance Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | None | $147.91 | $151.36 | $151.36 |
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 $52.48 Median $61.66 Typical High $77.62 | Professional | 52 · Reduced service | $52.48 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $21.38 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.20 Typical High $23.44 | Professional | 55 · Aftercare only | $15.85 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.30 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.72 | $12.30 | $15.49 |
Where Hawaii sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 22nd of 51
$148
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.