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 $17.38 Median $18.20 Typical High $23.99 | Professional | None | $17.38 | $18.20 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
HMSA Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.98 Median $20.42 Typical High $25.70 | Professional | None | $16.98 | $20.42 | $25.70 |
United Setting Professional Modifier None Typical Low $16.98 Median $19.50 Typical High $19.50 | Professional | None | $16.98 | $19.50 | $19.50 |
University Health Alliance Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
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 $8.51 Median $8.51 Typical High $9.55 | Professional | 52 · Reduced service | $8.51 | $8.51 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.80 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.91 |
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· 25th of 51
$17.38
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.