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 $39.81 Median $54.95 Typical High $138.04 | Professional | None | $39.81 | $54.95 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
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 $56.23 Median $56.23 Typical High $61.66 | Professional | None | $56.23 | $56.23 | $61.66 |
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 $19.95 Median $27.54 Typical High $69.18 | Professional | 52 · Reduced service | $19.95 | $27.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.96 Typical High $27.54 | Professional | 53 · Discontinued | $7.94 | $10.96 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.13 Typical High $20.89 | Professional | 55 · Aftercare only | $5.89 | $8.13 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.50 Typical High $13.80 | Professional | 56 · Pre-op care only | $3.98 | $5.50 | $13.80 |
Where Hawaii sits
The same service costs 4.6 times more in New York 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· 42nd of 51
$56.23
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.