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 $371.54 Median $467.74 Typical High $645.65 | Professional | None | $371.54 | $467.74 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
HMSA Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $575.44 | Professional | None | $467.74 | $537.03 | $575.44 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $269.15 Typical High $288.40 | Professional | 51 · Multiple procedures | $234.42 | $269.15 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $794.33 | Professional | None | $549.54 | $645.65 | $794.33 |
United Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | None | $562.34 | $616.60 | $616.60 |
University Health Alliance Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | None | $602.56 | $616.60 | $616.60 |
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 $186.21 Median $234.42 Typical High $323.59 | Professional | 52 · Reduced service | $186.21 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $93.33 Typical High $128.82 | Professional | 53 · Discontinued | $74.13 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $70.79 Typical High $95.50 | Professional | 55 · Aftercare only | $56.23 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $46.77 Typical High $64.57 | Professional | 56 · Pre-op care only | $37.15 | $46.77 | $64.57 |
Where Hawaii sits
The same service costs 3.2 times more in Alaska 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.
Hawaii· 19th of 51
$603
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.