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 $31.62 Median $33.11 Typical High $44.67 | Professional | None | $31.62 | $33.11 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | None | $52.48 | $61.66 | $61.66 |
HMSA Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $53.70 | Professional | None | $35.48 | $42.66 | $53.70 |
United Setting Professional Modifier None Typical Low $35.48 Median $61.66 Typical High $61.66 | Professional | None | $35.48 | $61.66 | $61.66 |
University Health Alliance Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $15.85 Median $16.22 Typical High $23.44 | Professional | 52 · Reduced service | $15.85 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $9.33 | Professional | 53 · Discontinued | $6.46 | $6.46 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $7.08 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $4.68 |
Where Hawaii sits
The same service costs 1.7 times more in Hawaii than in Kentucky. 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· 1st of 51
$54.95
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.