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 $5.75 Median $5.75 Typical High $6.31 | Professional | None | $5.75 | $5.75 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $6.61 Median $6.92 Typical High $6.92 | Professional | None | $6.61 | $6.92 | $6.92 |
HMSA Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.75 Median $6.92 Typical High $8.51 | Professional | None | $5.75 | $6.92 | $8.51 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.92 Typical High $6.92 | Professional | None | $5.75 | $6.92 | $6.92 |
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 $2.88 Median $2.88 Typical High $3.16 | Professional | 52 · Reduced service | $2.88 | $2.88 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.15 Typical High $1.26 | Professional | 53 · Discontinued | $1.15 | $1.15 | $1.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.85 Typical High $0.95 | Professional | 55 · Aftercare only | $0.85 | $0.85 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.63 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.63 |
Where Hawaii sits
The same service costs 1.5 times more in Alaska than in Pennsylvania. 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
$6.92
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.