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 $691.83 Median $2,818.38 Typical High $2,884.03 | Facility | None | $691.83 | $2,818.38 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $562.34 | Professional | None | $199.53 | $338.84 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,174.90 | Facility | None | $724.44 | $812.83 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | None | $446.68 | $524.81 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $489.78 Typical High $602.56 | Professional | None | $204.17 | $489.78 | $602.56 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,737.80 | Facility | None | $1,202.26 | $1,380.38 | $1,737.80 |
United Setting Professional Modifier None Typical Low $281.84 Median $524.81 Typical High $524.81 | Professional | None | $281.84 | $524.81 | $524.81 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $275.42 Typical High $588.84 | Professional | None | $29.51 | $275.42 | $588.84 |
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 $100.00 Median $169.82 Typical High $275.42 | Professional | 52 · Reduced service | $100.00 | $169.82 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $67.61 Typical High $109.65 | Professional | 53 · Discontinued | $39.81 | $67.61 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $257.04 Typical High $407.38 | Professional | 54 · Surgery only | $151.36 | $257.04 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $51.29 Typical High $83.18 | Professional | 55 · Aftercare only | $30.20 | $51.29 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $33.88 Typical High $54.95 | Professional | 56 · Pre-op care only | $19.95 | $33.88 | $54.95 |
Where Hawaii sits
The same service costs 3.8 times more in Alaska 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· 13th of 51
$501
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.