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 $51.29 Median $74.13 Typical High $109.65 | Professional | None | $51.29 | $74.13 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $102.33 Typical High $102.33 | Professional | None | $48.98 | $102.33 | $102.33 |
HMSA Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $117.49 | Professional | None | $112.20 | $114.82 | $117.49 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 51 · Multiple procedures | $56.23 | $56.23 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
United Setting Professional Modifier None Typical Low $46.77 Median $102.33 Typical High $165.96 | Professional | None | $46.77 | $102.33 | $165.96 |
University Health Alliance Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
5 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 $25.70 Median $37.15 Typical High $54.95 | Professional | 52 · Reduced service | $25.70 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $14.79 Typical High $21.88 | Professional | 53 · Discontinued | $10.23 | $14.79 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $11.22 Typical High $16.60 | Professional | 55 · Aftercare only | $7.59 | $11.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.41 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.13 | $7.41 | $10.96 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Hawaii sits
The same service costs 3.0 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· 3rd of 51
$117
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.