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 $0.31 Median $0.50 Typical High $0.71 | Professional | None | $0.31 | $0.50 | $0.71 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
HMSA Setting Professional Modifier None Typical Low $0.76 Median $0.79 Typical High $0.79 | Professional | None | $0.76 | $0.79 | $0.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
United Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $1.00 | Professional | None | $0.38 | $0.38 | $1.00 |
2 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 55 · Aftercare only Typical Low $0.05 Median $0.08 Typical High $0.11 | Professional | 55 · Aftercare only | $0.05 | $0.08 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.05 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.03 | $0.05 | $0.07 |
Where Hawaii sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 14th of 51
$0.76
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.