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 $95.50 Median $109.65 Typical High $154.88 | Professional | None | $95.50 | $109.65 | $154.88 |
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 $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
HMSA Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $177.83 | Professional | None | $138.04 | $162.18 | $177.83 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $81.28 Typical High $89.13 | Professional | 51 · Multiple procedures | $69.18 | $81.28 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $123.03 | Professional | None | $83.18 | $97.72 | $123.03 |
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 $117.49 Median $117.49 Typical High $120.23 | Professional | None | $117.49 | $117.49 | $120.23 |
University Health Alliance Setting Professional Modifier None Typical Low $16.22 Median $29.51 Typical High $128.82 | Professional | None | $16.22 | $29.51 | $128.82 |
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 $47.86 Median $54.95 Typical High $77.62 | Professional | 52 · Reduced service | $47.86 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $21.88 Typical High $30.90 | Professional | 53 · Discontinued | $19.05 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $83.18 Typical High $117.49 | Professional | 54 · Surgery only | $70.79 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $23.44 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.96 Typical High $15.49 | Professional | 56 · Pre-op care only | $9.55 | $10.96 | $15.49 |
Where Hawaii sits
The same service costs 4.0 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· 28th of 51
$129
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.