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 $77.62 Median $147.91 Typical High $251.19 | Professional | None | $77.62 | $147.91 | $251.19 |
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 $204.17 Median $263.03 Typical High $263.03 | Professional | None | $204.17 | $263.03 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $245.47 Typical High $309.03 | Professional | None | $89.13 | $245.47 | $309.03 |
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 $263.03 Typical High $263.03 | Professional | None | $109.65 | $263.03 | $263.03 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $112.20 Typical High $302.00 | Professional | None | $29.51 | $112.20 | $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 $38.90 Median $74.13 Typical High $125.89 | Professional | 52 · Reduced service | $38.90 | $74.13 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $29.51 Typical High $50.12 | Professional | 53 · Discontinued | $15.49 | $29.51 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $109.65 Typical High $186.21 | Professional | 54 · Surgery only | $58.88 | $109.65 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $22.39 Typical High $37.15 | Professional | 55 · Aftercare only | $11.75 | $22.39 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $14.79 Typical High $25.12 | Professional | 56 · Pre-op care only | $7.76 | $14.79 | $25.12 |
Where Hawaii sits
The same service costs 4.5 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· 9th of 51
$240
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.