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 $30.20 Typical High $30.90 | Professional | None | $28.84 | $30.20 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
HMSA Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
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 $29.51 Median $29.51 Typical High $30.20 | Professional | None | $29.51 | $29.51 | $30.20 |
University Health Alliance Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
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 $15.14 Typical High $15.49 | Professional | 52 · Reduced service | $14.45 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.03 Typical High $6.17 | Professional | 53 · Discontinued | $5.75 | $6.03 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.47 Typical High $4.57 | Professional | 55 · Aftercare only | $4.37 | $4.47 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.02 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.88 | $3.02 | $3.09 |
Where Hawaii sits
The same service costs 4.7 times more in Alaska than in Hawaii. 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· 51st of 51
$9.55
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.