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 $5.25 Median $5.50 Typical High $7.41 | Professional | None | $5.25 | $5.50 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
HMSA Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $5.89 Typical High $7.41 | Professional | None | $4.90 | $5.89 | $7.41 |
United Setting Professional Modifier None Typical Low $4.90 Median $7.94 Typical High $7.94 | Professional | None | $4.90 | $7.94 | $7.94 |
University Health Alliance Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
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 $2.63 Median $2.63 Typical High $3.31 | Professional | 52 · Reduced service | $2.63 | $2.63 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $2.40 | Professional | 53 · Discontinued | $1.07 | $1.07 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $1.82 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $1.20 |
Where Hawaii sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 2nd of 51
$7.94
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.