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 $38.02 Median $39.81 Typical High $52.48 | Professional | None | $38.02 | $39.81 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
HMSA Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $37.15 | Professional | None | $30.90 | $36.31 | $37.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $54.95 | Professional | None | $37.15 | $44.67 | $54.95 |
United Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $42.66 | Professional | None | $37.15 | $42.66 | $42.66 |
University Health Alliance Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $18.62 Median $18.62 Typical High $20.89 | Professional | 52 · Reduced service | $18.62 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $8.32 | Professional | 53 · Discontinued | $7.59 | $7.59 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $6.17 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.17 |
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· 51st of 51
$37.15
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.