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 $47.86 Median $67.61 Typical High $112.20 | Professional | None | $47.86 | $67.61 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $134.90 | Professional | None | $109.65 | $117.49 | $134.90 |
HMSA Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | None | $138.04 | $138.04 | $144.54 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 51 · Multiple procedures | $69.18 | $69.18 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $117.49 Typical High $128.82 | Professional | None | $46.77 | $117.49 | $128.82 |
United Setting Professional Modifier None Typical Low $46.77 Median $117.49 Typical High $134.90 | Professional | None | $46.77 | $117.49 | $134.90 |
University Health Alliance Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $23.99 Median $33.88 Typical High $56.23 | Professional | 52 · Reduced service | $23.99 | $33.88 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.80 Typical High $22.91 | Professional | 53 · Discontinued | $9.55 | $13.80 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.23 Typical High $16.98 | Professional | 55 · Aftercare only | $7.08 | $10.23 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.92 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.79 | $6.92 | $11.22 |
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 2.8 times more in Alaska than in Maryland. 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· 2nd of 51
$135
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.