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 $36.31 Median $46.77 Typical High $109.65 | Professional | None | $36.31 | $46.77 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $63.10 Median $85.11 Typical High $85.11 | Professional | None | $63.10 | $85.11 | $85.11 |
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 $18.20 Median $23.44 Typical High $54.95 | Professional | 52 · Reduced service | $18.20 | $23.44 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $9.33 Typical High $21.88 | Professional | 53 · Discontinued | $7.24 | $9.33 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $7.08 Typical High $16.22 | Professional | 55 · Aftercare only | $5.50 | $7.08 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.68 Typical High $10.96 | Professional | 56 · Pre-op care only | $3.63 | $4.68 | $10.96 |
Where Hawaii sits
The same service costs 4.0 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· 5th of 51
$85.11
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.