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 $28.84 Median $28.84 Typical High $37.15 | Professional | None | $28.84 | $28.84 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
HMSA Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $29.51 Typical High $37.15 | Professional | None | $24.55 | $29.51 | $37.15 |
United Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $28.18 | Professional | None | $24.55 | $28.18 | $28.18 |
University Health Alliance Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
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 $14.45 Median $14.45 Typical High $18.62 | Professional | 52 · Reduced service | $14.45 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $7.41 | Professional | 53 · Discontinued | $5.75 | $5.75 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.62 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.72 |
Where Hawaii sits
The same service costs 2.8 times more in Wyoming than in Arizona. 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· 48th of 51
$28.18
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.