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 $2,570.40 Median $6,025.60 Typical High $6,025.60 | Facility | None | $2,570.40 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $616.60 | Professional | None | $371.54 | $407.38 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $4,677.35 | Facility | None | $2,951.21 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
HMSA Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $691.83 | Professional | None | $537.03 | $630.96 | $691.83 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $316.23 Typical High $346.74 | Professional | 51 · Multiple procedures | $269.15 | $316.23 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $537.03 | Professional | None | $363.08 | $436.52 | $537.03 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $3,890.45 | Facility | None | $2,238.72 | $3,019.95 | $3,890.45 |
United Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $67.61 Typical High $537.03 | Professional | None | $29.51 | $67.61 | $537.03 |
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 $186.21 Median $204.17 Typical High $309.03 | Professional | 52 · Reduced service | $186.21 | $204.17 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $123.03 | Professional | 53 · Discontinued | $74.13 | $81.28 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $457.09 | Professional | 54 · Surgery only | $275.42 | $309.03 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $91.20 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $61.66 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $61.66 |
Where Hawaii sits
The same service costs 4.5 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· 28th of 51
$537
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.