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 $102.33 Median $120.23 Typical High $190.55 | Professional | None | $102.33 | $120.23 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
HMSA Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $186.21 | Professional | None | $144.54 | $169.82 | $186.21 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $28.84 Typical High $31.62 | Professional | AS · PA/NP assist | $24.55 | $28.84 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $154.88 | Professional | None | $102.33 | $123.03 | $154.88 |
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 $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
University Health Alliance Setting Professional Modifier None Typical Low $19.50 Median $29.51 Typical High $154.88 | Professional | None | $19.50 | $29.51 | $154.88 |
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 $52.48 Median $60.26 Typical High $93.33 | Professional | 52 · Reduced service | $52.48 | $60.26 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $23.99 Typical High $38.02 | Professional | 53 · Discontinued | $20.89 | $23.99 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $89.13 Typical High $141.25 | Professional | 54 · Surgery only | $79.43 | $89.13 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $17.78 Typical High $28.18 | Professional | 55 · Aftercare only | $15.85 | $17.78 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.02 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.47 | $12.02 | $18.62 |
Where Hawaii sits
The same service costs 4.3 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
$145
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.