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 $117.49 Typical High $158.49 | Professional | None | $81.28 | $117.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
HMSA Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $165.96 | Professional | None | $128.82 | $151.36 | $165.96 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $75.86 Typical High $83.18 | Professional | 51 · Multiple procedures | $64.57 | $75.86 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $128.82 | Professional | None | $87.10 | $104.71 | $128.82 |
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 $128.82 Median $131.83 Typical High $131.83 | Professional | None | $128.82 | $131.83 | $131.83 |
University Health Alliance Setting Professional Modifier None Typical Low $17.78 Median $29.51 Typical High $141.25 | Professional | None | $17.78 | $29.51 | $141.25 |
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 $57.54 Typical High $83.18 | Professional | 52 · Reduced service | $40.74 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $23.44 Typical High $33.11 | Professional | 53 · Discontinued | $16.22 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $87.10 Typical High $125.89 | Professional | 54 · Surgery only | $61.66 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $25.12 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.75 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.13 | $11.75 | $16.60 |
Where Hawaii sits
The same service costs 4.8 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
$132
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.