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 $8.71 Median $8.71 Typical High $9.55 | Professional | None | $8.71 | $8.71 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $9.55 Typical High $9.55 | Professional | None | $8.91 | $9.55 | $9.55 |
HMSA Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.71 Median $10.23 Typical High $12.88 | Professional | None | $8.71 | $10.23 | $12.88 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $9.55 | Professional | None | $8.71 | $9.55 | $9.55 |
University Health Alliance Setting Professional Modifier None Typical Low $8.71 Median $10.23 Typical High $14.79 | Professional | None | $8.71 | $10.23 | $14.79 |
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 $4.37 Median $4.37 Typical High $4.79 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.91 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.45 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $0.95 |
Where Hawaii sits
The same service costs 1.9 times more in Wyoming than in Mississippi. 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· 6th of 51
$9.55
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.