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 $81.28 Median $288.40 Typical High $467.74 | Professional | None | $81.28 | $288.40 | $467.74 |
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 $354.81 Median $436.52 Typical High $436.52 | Professional | None | $354.81 | $436.52 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $407.38 Typical High $512.86 | Professional | None | $91.20 | $407.38 | $512.86 |
United Setting Facility Modifier None Typical Low $269.15 Median $616.60 Typical High $1,122.02 | Facility | None | $269.15 | $616.60 | $1,122.02 |
United Setting Professional Modifier None Typical Low $112.20 Median $436.52 Typical High $436.52 | Professional | None | $112.20 | $436.52 | $436.52 |
University Health Alliance Setting Professional Modifier None Typical Low $75.86 Median $389.05 Typical High $489.78 | Professional | None | $75.86 | $389.05 | $489.78 |
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 $39.81 Median $144.54 Typical High $204.17 | Professional | 52 · Reduced service | $39.81 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $58.88 Typical High $81.28 | Professional | 53 · Discontinued | $15.85 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $218.78 Typical High $309.03 | Professional | 54 · Surgery only | $58.88 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $43.65 Typical High $61.66 | Professional | 55 · Aftercare only | $11.75 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $28.84 Typical High $40.74 | Professional | 56 · Pre-op care only | $7.94 | $28.84 | $40.74 |
Where Hawaii sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 6th of 51
$389
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.