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 $22.91 Median $295.12 Typical High $316.23 | Professional | None | $22.91 | $295.12 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
HMSA Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | None | $263.03 | $275.42 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
United Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
University Health Alliance Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | None | $204.17 | $223.87 | $223.87 |
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 $11.48 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $11.48 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $60.26 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $30.20 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.42 | $30.20 | $31.62 |
Where Hawaii sits
The same service costs 5.2 times more in Alaska than in Georgia. 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· 8th of 51
$263
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.