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 $25.70 Median $26.92 Typical High $36.31 | Professional | None | $25.70 | $26.92 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
HMSA Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $38.90 | Professional | None | $25.70 | $30.90 | $38.90 |
United Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | None | $25.70 | $27.54 | $27.54 |
University Health Alliance Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $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 $12.88 Median $13.18 Typical High $15.49 | Professional | 52 · Reduced service | $12.88 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.25 Typical High $6.17 | Professional | 53 · Discontinued | $5.13 | $5.25 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.68 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.63 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.57 | $2.63 | $3.09 |
Where Hawaii sits
Rates are fairly even across states for this service. 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
$27.54
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.