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 $85.11 Median $165.96 Typical High $239.88 | Professional | None | $85.11 | $165.96 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
HMSA Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | None | $89.13 | $93.33 | $93.33 |
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 $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
University Health Alliance Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | None | $89.13 | $97.72 | $97.72 |
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 $42.66 Median $83.18 Typical High $120.23 | Professional | 52 · Reduced service | $42.66 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $33.11 Typical High $47.86 | Professional | 53 · Discontinued | $16.98 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $25.12 Typical High $36.31 | Professional | 55 · Aftercare only | $12.88 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $16.60 Typical High $23.99 | Professional | 56 · Pre-op care only | $8.51 | $16.60 | $23.99 |
Where Hawaii sits
The same service costs 53.7 times more in Oklahoma than in Missouri. 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· 20th of 51
$89.13
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.