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 $91.20 Median $102.33 Typical High $144.54 | Professional | None | $91.20 | $102.33 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
HMSA Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $138.04 | Professional | None | $107.15 | $125.89 | $138.04 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $63.10 Typical High $69.18 | Professional | 51 · Multiple procedures | $53.70 | $63.10 | $69.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $177.83 | Professional | None | $117.49 | $141.25 | $177.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | None | $125.89 | $134.90 | $134.90 |
University Health Alliance Setting Professional Modifier None Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | None | $141.25 | $144.54 | $144.54 |
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 $45.71 Median $51.29 Typical High $72.44 | Professional | 52 · Reduced service | $45.71 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $28.84 | Professional | 53 · Discontinued | $18.20 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $21.88 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $14.45 |
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· 24th 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.