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 $54.95 Median $72.44 Typical High $100.00 | Professional | None | $54.95 | $72.44 | $100.00 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $107.15 | Professional | None | $60.26 | $83.18 | $107.15 |
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 $74.13 Median $97.72 Typical High $97.72 | Professional | None | $74.13 | $97.72 | $97.72 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $52.48 Typical High $104.71 | Professional | None | $29.51 | $52.48 | $104.71 |
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 $27.54 Median $36.31 Typical High $50.12 | Professional | 52 · Reduced service | $27.54 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.45 Typical High $19.95 | Professional | 53 · Discontinued | $10.96 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $53.70 Typical High $75.86 | Professional | 54 · Surgery only | $41.69 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.72 Typical High $15.14 | Professional | 55 · Aftercare only | $8.32 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.24 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.50 | $7.24 | $10.00 |
Where Hawaii sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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· 16th of 51
$97.72
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.