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 $26.92 Median $52.48 Typical High $117.49 | Professional | None | $26.92 | $52.48 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $109.65 | Professional | None | $89.13 | $109.65 | $109.65 |
HMSA Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $123.03 | Professional | None | $95.50 | $109.65 | $123.03 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $47.86 Median $54.95 Typical High $58.88 | Professional | 51 · Multiple procedures | $47.86 | $54.95 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.30 Median $87.10 Typical High $112.20 | Professional | None | $26.30 | $87.10 | $112.20 |
United Setting Professional Modifier None Typical Low $39.81 Median $109.65 Typical High $109.65 | Professional | None | $39.81 | $109.65 | $109.65 |
University Health Alliance Setting Professional Modifier None Typical Low $34.67 Median $81.28 Typical High $112.20 | Professional | None | $34.67 | $81.28 | $112.20 |
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 $13.49 Median $26.30 Typical High $51.29 | Professional | 52 · Reduced service | $13.49 | $26.30 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $10.72 Typical High $20.89 | Professional | 53 · Discontinued | $5.37 | $10.72 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $7.94 Typical High $15.49 | Professional | 55 · Aftercare only | $4.07 | $7.94 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $5.25 Typical High $10.23 | Professional | 56 · Pre-op care only | $2.69 | $5.25 | $10.23 |
Where Hawaii sits
The same service costs 3.6 times more in North Carolina 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· 5th 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.