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 $51.29 Median $66.07 Typical High $77.62 | Professional | None | $51.29 | $66.07 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
HMSA Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $128.82 | Professional | None | $95.50 | $112.20 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $131.83 | Professional | None | $74.13 | $81.28 | $131.83 |
United Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | None | $69.18 | $85.11 | $85.11 |
University Health Alliance Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $120.23 | Professional | None | $61.66 | $120.23 | $120.23 |
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 $26.92 Median $29.51 Typical High $38.90 | Professional | 52 · Reduced service | $26.92 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.91 Typical High $11.75 | Professional | 55 · Aftercare only | $8.13 | $8.91 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.89 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.37 | $5.89 | $7.76 |
Where Hawaii sits
The same service costs 4.3 times more in Minnesota 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· 13th of 51
$95.50
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.