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 $18.62 Median $27.54 Typical High $91.20 | Professional | None | $18.62 | $27.54 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $109.65 | Professional | None | $83.18 | $95.50 | $109.65 |
HMSA Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | None | $112.20 | $112.20 | $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 $19.50 Median $95.50 Typical High $104.71 | Professional | None | $19.50 | $95.50 | $104.71 |
United Setting Professional Modifier None Typical Low $32.36 Median $95.50 Typical High $109.65 | Professional | None | $32.36 | $95.50 | $109.65 |
University Health Alliance Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
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 $9.33 Median $13.80 Typical High $45.71 | Professional | 52 · Reduced service | $9.33 | $13.80 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $5.50 Typical High $18.20 | Professional | 53 · Discontinued | $3.72 | $5.50 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $4.07 Typical High $13.80 | Professional | 55 · Aftercare only | $2.82 | $4.07 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.75 Typical High $9.12 | Professional | 56 · Pre-op care only | $1.86 | $2.75 | $9.12 |
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 4.4 times more in Hawaii 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· 1st of 51
$110
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.