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 $239.88 Median $257.04 Typical High $389.05 | Professional | None | $239.88 | $257.04 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $346.74 | Professional | None | $229.09 | $275.42 | $346.74 |
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 $316.23 Median $316.23 Typical High $323.59 | Professional | None | $316.23 | $316.23 | $323.59 |
University Health Alliance Setting Professional Modifier None Typical Low $43.65 Median $346.74 Typical High $346.74 | Professional | None | $43.65 | $346.74 | $346.74 |
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 $117.49 Median $128.82 Typical High $194.98 | Professional | 52 · Reduced service | $117.49 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $79.43 | Professional | 53 · Discontinued | $47.86 | $51.29 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $38.90 |
Where Hawaii sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 32nd of 51
$316
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.