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 $58.88 Median $61.66 Typical High $81.28 | Professional | None | $58.88 | $61.66 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
HMSA Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $89.13 | Professional | None | $60.26 | $72.44 | $89.13 |
United Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $75.86 | Professional | None | $60.26 | $75.86 | $75.86 |
University Health Alliance Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $100.00 | Professional | None | $75.86 | $85.11 | $100.00 |
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 $28.84 Median $29.51 Typical High $32.36 | Professional | 52 · Reduced service | $28.84 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $12.88 | Professional | 53 · Discontinued | $11.75 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $9.77 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.46 |
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· 3rd of 51
$75.86
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.