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 $1.10 Median $1.10 Typical High $1.20 | Professional | None | $1.10 | $1.10 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
HMSA Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.02 Median $1.23 Typical High $1.55 | Professional | None | $1.02 | $1.23 | $1.55 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.48 Typical High $1.48 | Professional | None | $1.02 | $1.48 | $1.48 |
University Health Alliance Setting Professional Modifier None Typical Low $1.58 Median $1.86 Typical High $2.14 | Professional | None | $1.58 | $1.86 | $2.14 |
3 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 $0.55 Median $0.55 Typical High $0.60 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.24 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.18 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.18 |
Where Hawaii sits
The same service costs 2.7 times more in Wyoming than in Alabama. 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· 2nd of 51
$1.48
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.