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 $2.14 Median $2.24 Typical High $2.95 | Professional | None | $2.14 | $2.24 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $2.75 Median $3.24 Typical High $3.24 | Professional | None | $2.75 | $3.24 | $3.24 |
HMSA Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.19 Median $2.57 Typical High $3.24 | Professional | None | $2.19 | $2.57 | $3.24 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.24 Typical High $3.24 | Professional | None | $2.19 | $3.24 | $3.24 |
University Health Alliance Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | None | $1.70 | $1.70 | $1.70 |
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 $1.07 Median $1.07 Typical High $1.17 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.47 | Professional | 53 · Discontinued | $0.43 | $0.43 | $0.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.35 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.23 |
Where Hawaii sits
The same service costs 1.9 times more in Wyoming than in Maine. 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
$2.63
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.