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 $79.43 Median $89.13 Typical High $112.20 | Professional | None | $79.43 | $89.13 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
HMSA Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $169.82 | Professional | None | $138.04 | $158.49 | $169.82 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $79.43 Typical High $85.11 | Professional | 51 · Multiple procedures | $67.61 | $79.43 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $114.82 | Professional | None | $77.62 | $91.20 | $114.82 |
United Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
University Health Alliance Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | None | $104.71 | $107.15 | $107.15 |
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 $39.81 Median $44.67 Typical High $56.23 | Professional | 52 · Reduced service | $39.81 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $22.39 | Professional | 53 · Discontinued | $15.85 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.49 Typical High $16.98 | Professional | 55 · Aftercare only | $12.02 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.94 | $8.91 | $11.22 |
Where Hawaii sits
The same service costs 3.1 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· 23rd of 51
$107
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.