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 $60.26 Median $63.10 Typical High $83.18 | Professional | None | $60.26 | $63.10 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | None | $147.91 | $158.49 | $158.49 |
HMSA Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $114.82 | Professional | None | $77.62 | $91.20 | $114.82 |
United Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $158.49 | Professional | None | $77.62 | $158.49 | $158.49 |
University Health Alliance Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $186.21 | Professional | None | $107.15 | $138.04 | $186.21 |
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 $30.20 Median $30.20 Typical High $63.10 | Professional | 52 · Reduced service | $30.20 | $30.20 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $25.12 | Professional | 53 · Discontinued | $12.02 | $12.02 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.12 Typical High $19.05 | Professional | 55 · Aftercare only | $8.91 | $9.12 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $12.59 |
Where Hawaii sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 1st of 51
$158
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.