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 $331.13 Median $331.13 Typical High $363.08 | Professional | None | $331.13 | $331.13 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
HMSA Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $363.08 | Professional | None | $309.03 | $316.23 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $489.78 | Professional | None | $323.59 | $389.05 | $489.78 |
United Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $371.54 | Professional | None | $323.59 | $371.54 | $371.54 |
University Health Alliance Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $478.63 | Professional | None | $363.08 | $380.19 | $478.63 |
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 $165.96 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | 53 · Discontinued | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $54.95 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $36.31 |
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· 4th of 51
$372
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.