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 $8.13 Median $8.71 Typical High $11.48 | Professional | None | $8.13 | $8.71 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
HMSA Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.71 Median $10.47 Typical High $13.18 | Professional | None | $8.71 | $10.47 | $13.18 |
United Setting Professional Modifier None Typical Low $8.71 Median $13.49 Typical High $13.49 | Professional | None | $8.71 | $13.49 | $13.49 |
University Health Alliance Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
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 $4.07 Median $4.17 Typical High $9.33 | Professional | 52 · Reduced service | $4.07 | $4.17 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.66 Typical High $3.80 | Professional | 53 · Discontinued | $1.62 | $1.66 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $2.82 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.83 Typical High $1.91 | Professional | 56 · Pre-op care only | $0.81 | $0.83 | $1.91 |
Where Hawaii sits
The same service costs 1.9 times more in Wyoming than in Georgia. 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
$13.49
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.