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 $295.12 Median $309.03 Typical High $316.23 | Professional | None | $295.12 | $309.03 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
HMSA Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $676.08 | Professional | None | $5.01 | $5.01 | $676.08 |
United Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
University Health Alliance Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $147.91 Median $154.88 Typical High $158.49 | Professional | 52 · Reduced service | $147.91 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $63.10 | Professional | 53 · Discontinued | $58.88 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $46.77 Typical High $47.86 | Professional | 55 · Aftercare only | $44.67 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $31.62 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $31.62 |
Where Hawaii sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 46th of 51
$309
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.