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 $114.82 Median $186.21 Typical High $263.03 | Professional | None | $114.82 | $186.21 | $263.03 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
HMSA Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $251.19 | Professional | None | $194.98 | $229.09 | $251.19 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $114.82 Typical High $125.89 | Professional | 51 · Multiple procedures | $97.72 | $114.82 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $213.80 | Professional | None | $144.54 | $173.78 | $213.80 |
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 $204.17 Median $204.17 Typical High $208.93 | Professional | None | $204.17 | $204.17 | $208.93 |
University Health Alliance Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $229.09 | Professional | None | $28.84 | $29.51 | $229.09 |
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 $57.54 Median $93.33 Typical High $131.83 | Professional | 52 · Reduced service | $57.54 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $37.15 Typical High $52.48 | Professional | 53 · Discontinued | $22.91 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $138.04 Typical High $194.98 | Professional | 54 · Surgery only | $85.11 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $27.54 Typical High $39.81 | Professional | 55 · Aftercare only | $16.98 | $27.54 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.62 Typical High $26.30 | Professional | 56 · Pre-op care only | $11.48 | $18.62 | $26.30 |
Where Hawaii sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 26th of 51
$204
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.