How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $2,884.03 | Facility | None | $1,000.00 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $77.62 | Professional | None | $48.98 | $56.23 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
HMSA Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $91.20 | Professional | None | $70.79 | $83.18 | $91.20 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $35.48 Median $41.69 Typical High $45.71 | Professional | 51 · Multiple procedures | $35.48 | $41.69 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $63.10 | Professional | None | $41.69 | $50.12 | $63.10 |
United Setting Facility Modifier None Typical Low $269.15 Median $616.60 Typical High $1,122.02 | Facility | None | $269.15 | $616.60 | $1,122.02 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
University Health Alliance Setting Professional Modifier None Typical Low $8.51 Median $29.51 Typical High $67.61 | Professional | None | $8.51 | $29.51 | $67.61 |
5 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 $24.55 Median $28.18 Typical High $38.90 | Professional | 52 · Reduced service | $24.55 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $11.48 Typical High $15.49 | Professional | 53 · Discontinued | $9.77 | $11.48 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $42.66 Typical High $58.88 | Professional | 54 · Surgery only | $36.31 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.51 Typical High $11.75 | Professional | 55 · Aftercare only | $7.24 | $8.51 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.62 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.90 | $5.62 | $7.76 |
Where Hawaii sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 31st of 51
$67.61
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.