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 $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,818.38 | $3,162.28 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
HMSA Setting Professional Modifier None Typical Low $4,677.35 Median $4,897.79 Typical High $5,248.07 | Professional | None | $4,677.35 | $4,897.79 | $5,248.07 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $2,344.23 Median $2,454.71 Typical High $2,630.27 | Professional | 51 · Multiple procedures | $2,344.23 | $2,454.71 | $2,630.27 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $794.33 Median $831.76 Typical High $891.25 | Professional | AS · PA/NP assist | $794.33 | $831.76 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $4,265.80 | Professional | None | $2,818.38 | $3,388.44 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $2,511.89 | Facility | None | $1,148.15 | $1,202.26 | $2,511.89 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,890.45 | Professional | None | $3,715.35 | $3,715.35 | $3,890.45 |
University Health Alliance Setting Professional Modifier None Typical Low $3,715.35 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,715.35 | $4,073.80 | $4,073.80 |
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 $1,412.54 Median $1,584.89 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,412.54 | $1,584.89 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $630.96 Typical High $977.24 | Professional | 53 · Discontinued | $562.34 | $630.96 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,344.23 Typical High $3,715.35 | Professional | 54 · Surgery only | $2,089.30 | $2,344.23 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $467.74 Typical High $741.31 | Professional | 55 · Aftercare only | $426.58 | $467.74 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $316.23 Typical High $489.78 | Professional | 56 · Pre-op care only | $281.84 | $316.23 | $489.78 |
Where Hawaii sits
The same service costs 5.2 times more in Alaska than in Texas. 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· 23rd of 51
$4,074
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.