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 $43.65 Median $45.71 Typical High $60.26 | Professional | None | $43.65 | $45.71 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
HMSA Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $63.10 | Professional | None | $42.66 | $50.12 | $63.10 |
United Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $48.98 | Professional | None | $42.66 | $48.98 | $48.98 |
University Health Alliance Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
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 $21.88 Median $21.88 Typical High $23.99 | Professional | 52 · Reduced service | $21.88 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $9.55 | Professional | 53 · Discontinued | $8.71 | $8.71 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $7.24 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.79 |
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· 11th of 51
$44.67
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.