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 $45.71 Median $104.71 Typical High $169.82 | Professional | None | $45.71 | $104.71 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $173.78 | Professional | None | $131.83 | $173.78 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $162.18 Typical High $204.17 | Professional | None | $50.12 | $162.18 | $204.17 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,148.15 | Facility | None | $794.33 | $1,047.13 | $1,148.15 |
United Setting Professional Modifier None Typical Low $61.66 Median $173.78 Typical High $173.78 | Professional | None | $61.66 | $173.78 | $173.78 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $64.57 Typical High $177.83 | Professional | None | $29.51 | $64.57 | $177.83 |
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 $22.91 Median $48.98 Typical High $74.13 | Professional | 52 · Reduced service | $22.91 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $19.50 Typical High $30.20 | Professional | 53 · Discontinued | $9.12 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $74.13 Typical High $112.20 | Professional | 54 · Surgery only | $33.88 | $74.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $14.79 Typical High $22.39 | Professional | 55 · Aftercare only | $6.92 | $14.79 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $9.77 Typical High $15.14 | Professional | 56 · Pre-op care only | $4.57 | $9.77 | $15.14 |
Where Hawaii sits
The same service costs 3.5 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· 12th of 51
$141
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.