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 $263.03 Median $371.54 Typical High $512.86 | Professional | None | $263.03 | $371.54 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
HMSA Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $512.86 | Professional | None | $478.63 | $501.19 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $630.96 | Professional | None | $398.11 | $512.86 | $630.96 |
United Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $588.84 | Professional | None | $446.68 | $588.84 | $588.84 |
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 $151.36 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $151.36 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $60.26 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $63.10 Typical High $72.44 | Professional | 55 · Aftercare only | $45.71 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.20 | $41.69 | $47.86 |
Where Hawaii sits
The same service costs 2.1 times more in Wyoming 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· 12th of 51
$513
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.