How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $63.10 Typical High $93.33 | Professional | None | $39.81 | $63.10 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | None | $74.13 | $93.33 | $93.33 |
HMSA Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $44.67 | Professional | None | $25.12 | $30.20 | $44.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $95.50 | Professional | None | $45.71 | $77.62 | $95.50 |
United Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $93.33 | Professional | None | $64.57 | $93.33 | $93.33 |
University Health Alliance Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $104.71 | Professional | None | $69.18 | $104.71 | $104.71 |
3 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 $19.05 Median $27.54 Typical High $38.02 | Professional | 52 · Reduced service | $19.05 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.32 Typical High $11.48 | Professional | 55 · Aftercare only | $5.75 | $8.32 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.50 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.80 | $5.50 | $7.59 |
Where Hawaii sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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
$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.