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 $29.51 Median $30.90 Typical High $32.36 | Professional | None | $29.51 | $30.90 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
HMSA Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
United Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | None | $30.90 | $36.31 | $36.31 |
University Health Alliance Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
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 $14.79 Median $15.14 Typical High $16.22 | Professional | 52 · Reduced service | $14.79 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.17 Typical High $6.46 | Professional | 53 · Discontinued | $5.89 | $6.17 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $4.90 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.09 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.95 | $3.09 | $3.24 |
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· 2nd of 51
$36.31
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.