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 $18.20 Median $23.44 Typical High $36.31 | Professional | None | $18.20 | $23.44 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
United Setting Professional Modifier None Typical Low $30.90 Median $42.66 Typical High $42.66 | Professional | None | $30.90 | $42.66 | $42.66 |
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 $9.12 Median $11.75 Typical High $18.20 | Professional | 52 · Reduced service | $9.12 | $11.75 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.68 Typical High $7.24 | Professional | 53 · Discontinued | $3.63 | $4.68 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.55 Typical High $5.37 | Professional | 55 · Aftercare only | $2.75 | $3.55 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.34 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.82 | $2.34 | $3.63 |
Where Hawaii sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 3rd of 51
$42.66
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.