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 $208.93 Median $251.19 Typical High $346.74 | Professional | None | $208.93 | $251.19 | $346.74 |
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 $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $302.00 | Professional | None | $204.17 | $245.47 | $302.00 |
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 $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
University Health Alliance Setting Professional Modifier None Typical Low $38.02 Median $218.78 Typical High $302.00 | Professional | None | $38.02 | $218.78 | $302.00 |
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 $125.89 Typical High $173.78 | Professional | 52 · Reduced service | $104.71 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $50.12 Typical High $69.18 | Professional | 53 · Discontinued | $41.69 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $186.21 Typical High $257.04 | Professional | 54 · Surgery only | $158.49 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $37.15 Typical High $51.29 | Professional | 55 · Aftercare only | $31.62 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $25.12 Typical High $34.67 | Professional | 56 · Pre-op care only | $20.89 | $25.12 | $34.67 |
Where Hawaii sits
The same service costs 4.7 times more in Wyoming 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· 32nd 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.