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 $85.11 Median $109.65 Typical High $138.04 | Professional | None | $85.11 | $109.65 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | None | $138.04 | $138.04 | $158.49 |
HMSA Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $173.78 | Professional | None | $147.91 | $165.96 | $173.78 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $83.18 Typical High $87.10 | Professional | 51 · Multiple procedures | $72.44 | $83.18 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $154.88 | Professional | None | $85.11 | $141.25 | $154.88 |
United Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | None | $138.04 | $138.04 | $158.49 |
University Health Alliance Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $42.66 Median $53.70 Typical High $67.61 | Professional | 52 · Reduced service | $42.66 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $21.88 Typical High $27.54 | Professional | 53 · Discontinued | $17.38 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.22 Typical High $20.42 | Professional | 55 · Aftercare only | $12.88 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.72 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.51 | $10.72 | $13.80 |
Where Hawaii sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 6th of 51
$158
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.