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 $70.79 Median $74.13 Typical High $97.72 | Professional | None | $70.79 | $74.13 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
HMSA Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $109.65 | Professional | None | $74.13 | $89.13 | $109.65 |
United Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | None | $74.13 | $93.33 | $93.33 |
University Health Alliance Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $35.48 Median $35.48 Typical High $39.81 | Professional | 52 · Reduced service | $35.48 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $16.22 | Professional | 53 · Discontinued | $14.13 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $12.02 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.94 |
Where Hawaii sits
The same service costs 1.5 times more in Wyoming than in Florida. 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
$91.20
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.