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 $13.49 Median $16.60 Typical High $22.39 | Professional | None | $13.49 | $16.60 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
HMSA Setting Professional Modifier None Typical Low $16.60 Median $19.05 Typical High $20.89 | Professional | None | $16.60 | $19.05 | $20.89 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $8.32 Median $9.55 Typical High $10.47 | Professional | 51 · Multiple procedures | $8.32 | $9.55 | $10.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $27.54 | Professional | None | $18.62 | $21.88 | $27.54 |
United Setting Professional Modifier None Typical Low $19.95 Median $21.38 Typical High $21.38 | Professional | None | $19.95 | $21.38 | $21.38 |
University Health Alliance Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | None | $20.89 | $21.38 | $21.38 |
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 $6.61 Median $8.32 Typical High $11.22 | Professional | 52 · Reduced service | $6.61 | $8.32 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $3.31 Typical High $4.47 | Professional | 53 · Discontinued | $2.69 | $3.31 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.45 Typical High $3.39 | Professional | 55 · Aftercare only | $2.00 | $2.45 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.66 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.35 | $1.66 | $2.24 |
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· 18th of 51
$21.38
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.