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 $104.71 Median $144.54 Typical High $204.17 | Professional | None | $104.71 | $144.54 | $204.17 |
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 $173.78 Median $213.80 Typical High $213.80 | Professional | None | $173.78 | $213.80 | $213.80 |
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 $128.82 Median $177.83 Typical High $229.09 | Professional | None | $128.82 | $177.83 | $229.09 |
United Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | None | $165.96 | $213.80 | $213.80 |
University Health Alliance Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $223.87 | Professional | None | $151.36 | $223.87 | $223.87 |
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 $51.29 Median $64.57 Typical High $85.11 | Professional | 52 · Reduced service | $51.29 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $16.98 |
Where Hawaii sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 7th of 51
$214
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.