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 $208.93 Median $281.84 Typical High $389.05 | Professional | None | $208.93 | $281.84 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
HMSA Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $346.74 | Professional | None | $281.84 | $323.59 | $346.74 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $162.18 Typical High $173.78 | Professional | 51 · Multiple procedures | $141.25 | $162.18 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $478.63 | Professional | None | $323.59 | $389.05 | $478.63 |
United Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | None | $316.23 | $371.54 | $371.54 |
University Health Alliance Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $575.44 | Professional | None | $426.58 | $575.44 | $575.44 |
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 $102.33 Median $138.04 Typical High $186.21 | Professional | 52 · Reduced service | $102.33 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $74.13 | Professional | 53 · Discontinued | $40.74 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $41.69 Typical High $54.95 | Professional | 55 · Aftercare only | $30.90 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $37.15 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $37.15 |
Where Hawaii sits
The same service costs 2.8 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· 16th of 51
$372
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.