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 $407.38 Median $407.38 Typical High $446.68 | Professional | None | $407.38 | $407.38 | $446.68 |
HMSA Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $588.84 | Professional | None | $389.05 | $467.74 | $588.84 |
United Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | None | $389.05 | $436.52 | $436.52 |
University Health Alliance Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $467.74 | Professional | None | $346.74 | $380.19 | $467.74 |
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 $204.17 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $81.28 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $44.67 |
Where Hawaii sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 33rd of 51
$407
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.