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 $79.43 Median $776.25 Typical High $1,174.90 | Professional | None | $79.43 | $776.25 | $1,174.90 |
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 $831.76 Median $1,230.27 Typical High $1,230.27 | Professional | None | $831.76 | $1,230.27 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $1,148.15 Typical High $1,380.38 | Professional | None | $89.13 | $1,148.15 | $1,380.38 |
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 $109.65 Median $1,230.27 Typical High $1,230.27 | Professional | None | $109.65 | $1,230.27 | $1,230.27 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $112.20 Typical High $1,479.11 | Professional | None | $29.51 | $112.20 | $1,479.11 |
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 $38.90 Median $389.05 Typical High $588.84 | Professional | 52 · Reduced service | $38.90 | $389.05 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $154.88 Typical High $234.42 | Professional | 53 · Discontinued | $15.85 | $154.88 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $588.84 Typical High $870.96 | Professional | 54 · Surgery only | $58.88 | $588.84 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $117.49 Typical High $173.78 | Professional | 55 · Aftercare only | $11.75 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $77.62 Typical High $117.49 | Professional | 56 · Pre-op care only | $7.94 | $77.62 | $117.49 |
Where Hawaii sits
The same service costs 14.1 times more in Washington than in Kentucky. 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· 7th of 51
$1,023
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.