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 $104.71 Median $104.71 Typical High $131.83 | Professional | None | $104.71 | $104.71 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
HMSA Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $181.97 | Professional | None | $120.23 | $144.54 | $181.97 |
United Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $162.18 | Professional | None | $120.23 | $162.18 | $162.18 |
University Health Alliance Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $436.52 | Professional | None | $107.15 | $158.49 | $436.52 |
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 $52.48 Median $52.48 Typical High $93.33 | Professional | 52 · Reduced service | $52.48 | $52.48 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $37.15 | Professional | 53 · Discontinued | $20.89 | $21.38 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $28.18 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $18.62 |
Where Hawaii sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 3rd of 51
$162
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.