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 $0.85 Median $0.85 Typical High $1.07 | Professional | None | $0.85 | $0.85 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | None | $0.95 | $0.95 | $0.95 |
HMSA Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $1.23 Typical High $1.51 | Professional | None | $1.00 | $1.23 | $1.51 |
United Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $1.00 | Professional | None | $0.95 | $0.95 | $1.00 |
University Health Alliance Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.02 | Professional | None | $0.91 | $0.91 | $1.02 |
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 $0.43 Median $0.43 Typical High $0.54 | Professional | 52 · Reduced service | $0.43 | $0.43 | $0.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.22 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.16 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.11 |
Where Hawaii sits
The same service costs 3.7 times more in North Carolina than in Virginia. 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· 15th of 51
$0.95
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.