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 $87.10 Median $109.65 Typical High $169.82 | Professional | None | $87.10 | $109.65 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | None | $134.90 | $147.91 | $147.91 |
HMSA Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $162.18 | Professional | None | $125.89 | $147.91 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $177.83 | Professional | None | $109.65 | $141.25 | $177.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | None | $120.23 | $147.91 | $147.91 |
University Health Alliance Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $147.91 | Professional | None | $107.15 | $147.91 | $147.91 |
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 $41.69 Median $48.98 Typical High $63.10 | Professional | 52 · Reduced service | $41.69 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.14 Typical High $19.05 | Professional | 55 · Aftercare only | $12.59 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.51 | $10.00 | $12.59 |
Where Hawaii sits
The same service costs 2.7 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· 18th of 51
$148
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.