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 $234.42 Median $407.38 Typical High $912.01 | Professional | None | $234.42 | $407.38 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
HMSA Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,023.29 | Professional | None | $870.96 | $977.24 | $1,023.29 |
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 $117.49 Median $204.17 Typical High $457.09 | Professional | 52 · Reduced service | $117.49 | $204.17 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $81.28 Typical High $181.97 | Professional | 53 · Discontinued | $46.77 | $81.28 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $60.26 Typical High $138.04 | Professional | 55 · Aftercare only | $35.48 | $60.26 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $40.74 Typical High $91.20 | Professional | 56 · Pre-op care only | $23.44 | $40.74 | $91.20 |
Where Hawaii sits
The same service costs 43.7 times more in North Carolina than in Vermont. 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
$977
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.