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 $48.98 Median $75.86 Typical High $100.00 | Professional | None | $48.98 | $75.86 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $93.33 | Professional | None | $67.61 | $67.61 | $93.33 |
HMSA Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $107.15 | Professional | None | $81.28 | $93.33 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $83.18 | Professional | None | $63.10 | $75.86 | $83.18 |
United Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $97.72 | Professional | None | $67.61 | $93.33 | $97.72 |
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 $24.55 Median $38.02 Typical High $50.12 | Professional | 52 · Reduced service | $24.55 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $15.14 Typical High $19.95 | Professional | 53 · Discontinued | $9.77 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $11.48 Typical High $15.14 | Professional | 55 · Aftercare only | $7.41 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.59 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.90 | $7.59 | $10.00 |
Where Hawaii sits
The same service costs 2.2 times more in Alaska than in Kentucky. 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· 10th of 51
$91.20
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.