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 $208.93 Median $239.88 Typical High $380.19 | Professional | None | $208.93 | $239.88 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
HMSA Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $371.54 | Professional | None | $281.84 | $338.84 | $371.54 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $57.54 Typical High $63.10 | Professional | AS · PA/NP assist | $48.98 | $57.54 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $309.03 | Professional | None | $208.93 | $251.19 | $309.03 |
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 $281.84 Median $281.84 Typical High $302.00 | Professional | None | $281.84 | $281.84 | $302.00 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $39.81 Typical High $316.23 | Professional | None | $29.51 | $39.81 | $316.23 |
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 $104.71 Median $120.23 Typical High $190.55 | Professional | 52 · Reduced service | $104.71 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $75.86 | Professional | 53 · Discontinued | $41.69 | $47.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $288.40 | Professional | 54 · Surgery only | $158.49 | $181.97 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $57.54 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $38.02 |
Where Hawaii sits
The same service costs 5.0 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· 33rd of 51
$282
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.