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 $36.31 Median $38.02 Typical High $51.29 | Professional | None | $36.31 | $38.02 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
HMSA Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $54.95 | Professional | None | $36.31 | $43.65 | $54.95 |
United Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $43.65 | Professional | None | $36.31 | $43.65 | $43.65 |
University Health Alliance Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $54.95 | Professional | None | $40.74 | $44.67 | $54.95 |
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 $18.20 Median $18.20 Typical High $19.95 | Professional | 52 · Reduced service | $18.20 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $8.13 | Professional | 53 · Discontinued | $7.41 | $7.41 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.07 |
Where Hawaii sits
Rates are fairly even across states for this service. 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· 3rd of 51
$43.65
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.