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 $93.33 Median $154.88 Typical High $269.15 | Professional | None | $93.33 | $154.88 | $269.15 |
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 $218.78 Median $275.42 Typical High $275.42 | Professional | None | $218.78 | $275.42 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $251.19 Typical High $316.23 | Professional | None | $102.33 | $251.19 | $316.23 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $2,570.40 | Facility | None | $2,041.74 | $2,511.89 | $2,570.40 |
United Setting Professional Modifier None Typical Low $128.82 Median $275.42 Typical High $275.42 | Professional | None | $128.82 | $275.42 | $275.42 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $131.83 Typical High $316.23 | Professional | None | $29.51 | $131.83 | $316.23 |
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 $46.77 Median $75.86 Typical High $134.90 | Professional | 52 · Reduced service | $46.77 | $75.86 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $30.90 Typical High $53.70 | Professional | 53 · Discontinued | $18.62 | $30.90 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $114.82 Typical High $199.53 | Professional | 54 · Surgery only | $69.18 | $114.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $22.91 Typical High $39.81 | Professional | 55 · Aftercare only | $13.80 | $22.91 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $15.14 Typical High $26.92 | Professional | 56 · Pre-op care only | $9.33 | $15.14 | $26.92 |
Where Hawaii sits
The same service costs 4.0 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
$251
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.