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 $28.84 Median $1,023.29 Typical High $1,445.44 | Professional | None | $28.84 | $1,023.29 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
HMSA Setting Professional Modifier None Typical Low $50.12 Median $1,621.81 Typical High $1,659.59 | Professional | None | $50.12 | $1,621.81 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $1,445.44 Typical High $1,862.09 | Professional | None | $33.88 | $1,445.44 | $1,862.09 |
United Setting Professional Modifier None Typical Low $45.71 Median $1,659.59 Typical High $1,659.59 | Professional | None | $45.71 | $1,659.59 | $1,659.59 |
University Health Alliance Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $16.60 Median $549.54 Typical High $676.08 | Professional | 52 · Reduced service | $16.60 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $229.09 Typical High $275.42 | Professional | 53 · Discontinued | $7.08 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $120.23 Typical High $144.54 | Professional | 56 · Pre-op care only | $102.33 | $120.23 | $144.54 |
Where Hawaii sits
The same service costs 49.0 times more in Hawaii than in Maryland. 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
$1,622
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.