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 $43.65 Median $56.23 Typical High $95.50 | Professional | None | $43.65 | $56.23 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
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 $74.13 Median $104.71 Typical High $104.71 | Professional | None | $74.13 | $104.71 | $104.71 |
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 $21.88 Median $28.18 Typical High $47.86 | Professional | 52 · Reduced service | $21.88 | $28.18 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.22 Typical High $19.05 | Professional | 53 · Discontinued | $8.91 | $11.22 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.51 Typical High $14.45 | Professional | 55 · Aftercare only | $6.61 | $8.51 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.62 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.37 | $5.62 | $9.55 |
Where Hawaii sits
The same service costs 3.0 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· 4th of 51
$105
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.