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 $117.49 Median $138.04 Typical High $190.55 | Professional | None | $117.49 | $138.04 | $190.55 |
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 $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
HMSA Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $204.17 | Professional | None | $158.49 | $186.21 | $204.17 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $93.33 Typical High $102.33 | Professional | 51 · Multiple procedures | $77.62 | $93.33 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $162.18 | Professional | None | $107.15 | $128.82 | $162.18 |
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 $144.54 Median $144.54 Typical High $154.88 | Professional | None | $144.54 | $144.54 | $154.88 |
University Health Alliance Setting Professional Modifier None Typical Low $19.95 Median $29.51 Typical High $158.49 | Professional | None | $19.95 | $29.51 | $158.49 |
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 $69.18 Typical High $97.72 | Professional | 52 · Reduced service | $57.54 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $22.91 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $104.71 Typical High $144.54 | Professional | 54 · Surgery only | $87.10 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $17.38 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.80 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.48 | $13.80 | $19.50 |
Where Hawaii sits
The same service costs 5.1 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· 29th of 51
$158
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.