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 $37.15 Median $120.23 Typical High $190.55 | Professional | None | $37.15 | $120.23 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $213.80 | Professional | None | $158.49 | $213.80 | $213.80 |
HMSA Setting Professional Modifier None Typical Low $67.61 Median $251.19 Typical High $251.19 | Professional | None | $67.61 | $251.19 | $251.19 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $125.89 Typical High $125.89 | Professional | 51 · Multiple procedures | $33.88 | $125.89 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $186.21 Typical High $234.42 | Professional | None | $42.66 | $186.21 | $234.42 |
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 $51.29 Median $213.80 Typical High $213.80 | Professional | None | $51.29 | $213.80 | $213.80 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $54.95 Typical High $239.88 | Professional | None | $29.51 | $54.95 | $239.88 |
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 $18.62 Median $60.26 Typical High $95.50 | Professional | 52 · Reduced service | $18.62 | $60.26 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $23.99 Typical High $38.02 | Professional | 53 · Discontinued | $7.59 | $23.99 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $91.20 Typical High $141.25 | Professional | 54 · Surgery only | $28.18 | $91.20 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $18.20 Typical High $28.84 | Professional | 55 · Aftercare only | $5.62 | $18.20 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $12.02 Typical High $19.05 | Professional | 56 · Pre-op care only | $3.72 | $12.02 | $19.05 |
Where Hawaii sits
The same service costs 4.6 times more in Wisconsin 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· 8th of 51
$178
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.