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 $28.18 Median $34.67 Typical High $48.98 | Professional | None | $28.18 | $34.67 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $77.62 Typical High $77.62 | Facility | None | $50.12 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
HMSA Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | None | $77.62 | $81.28 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $141.25 | Professional | None | $41.69 | $51.29 | $141.25 |
United Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $79.43 | Professional | None | $46.77 | $79.43 | $79.43 |
University Health Alliance Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $4.27 Median $6.31 Typical High $7.76 | Professional | 55 · Aftercare only | $4.27 | $6.31 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.37 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.82 | $4.37 | $5.13 |
Where Hawaii sits
The same service costs 6.6 times more in Hawaii than in Wyoming. 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· 1st of 51
$79.43
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.