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 $691.83 Median $2,818.38 Typical High $2,884.03 | Facility | None | $691.83 | $2,818.38 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $223.87 | Professional | None | $123.03 | $144.54 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,174.90 | Facility | None | $724.44 | $812.83 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $181.97 | Professional | None | $123.03 | $147.91 | $181.97 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $162.18 Typical High $177.83 | Professional | None | $29.51 | $162.18 | $177.83 |
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 $61.66 Median $72.44 Typical High $104.71 | Professional | 52 · Reduced service | $61.66 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.84 Typical High $41.69 | Professional | 53 · Discontinued | $24.55 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $107.15 Typical High $158.49 | Professional | 54 · Surgery only | $93.33 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.38 Typical High $31.62 | Professional | 55 · Aftercare only | $18.62 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.45 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.30 | $14.45 | $20.89 |
Where Hawaii sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 40th of 51
$166
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.