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 $64.57 Median $75.86 Typical High $104.71 | Professional | None | $64.57 | $75.86 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
HMSA Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $100.00 | Professional | None | $77.62 | $91.20 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $125.89 | Professional | None | $83.18 | $100.00 | $125.89 |
United Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | None | $91.20 | $93.33 | $93.33 |
University Health Alliance Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | None | $100.00 | $102.33 | $102.33 |
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 $32.36 Median $38.02 Typical High $52.48 | Professional | 52 · Reduced service | $32.36 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.14 Typical High $20.89 | Professional | 53 · Discontinued | $12.88 | $15.14 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.48 Typical High $15.49 | Professional | 55 · Aftercare only | $9.55 | $11.48 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.59 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.46 | $7.59 | $10.47 |
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· 27th of 51
$93.33
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.