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 $11.48 Median $12.30 Typical High $16.22 | Professional | None | $11.48 | $12.30 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
HMSA Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.80 Median $16.60 Typical High $20.89 | Professional | None | $13.80 | $16.60 | $20.89 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.42 Typical High $20.42 | Professional | None | $13.80 | $20.42 | $20.42 |
University Health Alliance Setting Professional Modifier None Typical Low $15.85 Median $20.89 Typical High $28.84 | Professional | None | $15.85 | $20.89 | $28.84 |
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 $5.75 Median $5.89 Typical High $7.59 | Professional | 52 · Reduced service | $5.75 | $5.89 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.34 Typical High $3.02 | Professional | 53 · Discontinued | $2.29 | $2.34 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.78 Typical High $2.24 | Professional | 55 · Aftercare only | $1.74 | $1.78 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.17 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.15 | $1.17 | $1.51 |
Where Hawaii sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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
$20.42
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.