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 $1,513.56 Median $3,890.45 Typical High $3,890.45 | Facility | None | $1,513.56 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $169.82 | Professional | None | $81.28 | $123.03 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
HMSA Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $186.21 | Professional | None | $154.88 | $169.82 | $186.21 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $85.11 Typical High $89.13 | Professional | 51 · Multiple procedures | $77.62 | $85.11 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $138.04 | Professional | None | $93.33 | $109.65 | $138.04 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,737.80 | Facility | None | $1,202.26 | $1,380.38 | $1,737.80 |
United Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
University Health Alliance Setting Professional Modifier None Typical Low $18.20 Median $29.51 Typical High $144.54 | Professional | None | $18.20 | $29.51 | $144.54 |
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 $40.74 Median $61.66 Typical High $83.18 | Professional | 52 · Reduced service | $40.74 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $24.55 Typical High $33.88 | Professional | 53 · Discontinued | $16.22 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $91.20 Typical High $125.89 | Professional | 54 · Surgery only | $60.26 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.20 Typical High $25.12 | Professional | 55 · Aftercare only | $12.02 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.30 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.13 | $12.30 | $16.98 |
Where Hawaii sits
The same service costs 5.1 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· 29th of 51
$138
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.