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 $75.86 Median $165.96 Typical High $239.88 | Professional | None | $75.86 | $165.96 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | None | $218.78 | $251.19 | $251.19 |
HMSA Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $316.23 | Professional | None | $177.83 | $295.12 | $316.23 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $147.91 Typical High $158.49 | Professional | 51 · Multiple procedures | $91.20 | $147.91 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $213.80 Typical High $269.15 | Professional | None | $74.13 | $213.80 | $269.15 |
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 $107.15 Median $251.19 Typical High $251.19 | Professional | None | $107.15 | $251.19 | $251.19 |
University Health Alliance Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $107.15 | Professional | None | $72.44 | $107.15 | $107.15 |
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 $38.02 Median $81.28 Typical High $117.49 | Professional | 52 · Reduced service | $38.02 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $33.11 Typical High $46.77 | Professional | 53 · Discontinued | $15.14 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $56.23 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $24.55 Typical High $34.67 | Professional | 55 · Aftercare only | $11.22 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $7.59 | $16.60 | $23.44 |
Where Hawaii sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 7th of 51
$251
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.