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 $41.69 Median $51.29 Typical High $52.48 | Professional | None | $41.69 | $51.29 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
HMSA Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
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 $10.72 Median $10.72 Typical High $50.12 | Professional | None | $10.72 | $10.72 | $50.12 |
University Health Alliance Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
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 $20.89 Median $25.12 Typical High $25.70 | Professional | 52 · Reduced service | $20.89 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.23 Typical High $10.47 | Professional | 53 · Discontinued | $8.51 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.59 Typical High $7.76 | Professional | 55 · Aftercare only | $6.31 | $7.59 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.13 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.27 | $5.13 | $5.25 |
Where Hawaii sits
The same service costs 6.6 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
$10.96
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.