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 $34.67 Median $48.98 Typical High $70.79 | Professional | None | $34.67 | $48.98 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
HMSA Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $77.62 | Professional | None | $66.07 | $74.13 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $56.23 | Professional | None | $41.69 | $51.29 | $56.23 |
United Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $70.79 | Professional | None | $44.67 | $61.66 | $70.79 |
4 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 $17.38 Median $24.55 Typical High $35.48 | Professional | 52 · Reduced service | $17.38 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $9.77 Typical High $14.13 | Professional | 53 · Discontinued | $6.92 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $7.24 Typical High $10.47 | Professional | 55 · Aftercare only | $5.25 | $7.24 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.90 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.47 | $4.90 | $7.08 |
Where Hawaii sits
The same service costs 2.2 times more in Alaska than in Arizona. 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· 16th of 51
$56.23
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.