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 $39.81 Median $58.88 Typical High $109.65 | Professional | None | $39.81 | $58.88 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $128.82 | Professional | None | $107.15 | $112.20 | $128.82 |
HMSA Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
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 $39.81 Median $114.82 Typical High $125.89 | Professional | None | $39.81 | $114.82 | $125.89 |
United Setting Professional Modifier None Typical Low $46.77 Median $112.20 Typical High $128.82 | Professional | None | $46.77 | $112.20 | $128.82 |
University Health Alliance Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
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 $19.95 Median $28.84 Typical High $54.95 | Professional | 52 · Reduced service | $19.95 | $28.84 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $11.48 Typical High $21.88 | Professional | 53 · Discontinued | $7.94 | $11.48 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.51 Typical High $16.60 | Professional | 55 · Aftercare only | $6.03 | $8.51 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.75 Typical High $10.96 | Professional | 56 · Pre-op care only | $3.98 | $5.75 | $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 2.5 times more in Alaska than in Washington, DC. 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
$129
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.