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 $57.54 Median $117.49 Typical High $218.78 | Professional | None | $57.54 | $117.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $158.49 | Professional | None | $112.20 | $141.25 | $158.49 |
HMSA Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | None | $199.53 | $199.53 | $208.93 |
United Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | None | $141.25 | $141.25 | $158.49 |
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 $28.84 Median $58.88 Typical High $109.65 | Professional | 52 · Reduced service | $28.84 | $58.88 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $23.99 Typical High $43.65 | Professional | 53 · Discontinued | $11.48 | $23.99 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $17.78 Typical High $33.11 | Professional | 55 · Aftercare only | $8.71 | $17.78 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $11.75 Typical High $21.88 | Professional | 56 · Pre-op care only | $5.75 | $11.75 | $21.88 |
Where Hawaii sits
The same service costs 3.0 times more in California than in New York. 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· 2nd of 51
$178
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.