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 $9.55 Median $10.00 Typical High $13.18 | Professional | None | $9.55 | $10.00 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
HMSA Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.13 Median $9.77 Typical High $12.30 | Professional | None | $8.13 | $9.77 | $12.30 |
United Setting Professional Modifier None Typical Low $8.13 Median $10.00 Typical High $10.00 | Professional | None | $8.13 | $10.00 | $10.00 |
University Health Alliance Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
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 $4.79 Median $4.79 Typical High $5.25 | Professional | 52 · Reduced service | $4.79 | $4.79 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $2.09 | Professional | 53 · Discontinued | $1.91 | $1.91 | $2.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.58 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $1.05 |
Where Hawaii sits
The same service costs 1.7 times more in Wyoming than in North Carolina. 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· 7th of 51
$10.00
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.