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 $0.48 Median $0.49 Typical High $0.62 | Professional | None | $0.48 | $0.49 | $0.62 |
Cigna Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | None | $0.83 | $0.83 | $0.83 |
HMSA Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.52 Median $0.62 Typical High $0.78 | Professional | None | $0.52 | $0.62 | $0.78 |
United Setting Professional Modifier None Typical Low $0.52 Median $0.83 Typical High $0.83 | Professional | None | $0.52 | $0.83 | $0.83 |
University Health Alliance Setting Professional Modifier None Typical Low $0.74 Median $0.91 Typical High $4.57 | Professional | None | $0.74 | $0.91 | $4.57 |
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 $0.25 Median $0.25 Typical High $1.95 | Professional | 52 · Reduced service | $0.25 | $0.25 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.78 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.58 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.58 |
Where Hawaii sits
The same service costs 2.6 times more in Wyoming than in Illinois. 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
$0.83
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.