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 $72.44 Median $194.98 Typical High $380.19 | Professional | None | $72.44 | $194.98 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $363.08 | Professional | None | $239.88 | $363.08 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $338.84 Typical High $426.58 | Professional | None | $79.43 | $338.84 | $426.58 |
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 $97.72 Median $363.08 Typical High $363.08 | Professional | None | $97.72 | $363.08 | $363.08 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $100.00 Typical High $426.58 | Professional | None | $29.51 | $100.00 | $426.58 |
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 $34.67 Median $91.20 Typical High $162.18 | Professional | 52 · Reduced service | $34.67 | $91.20 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $37.15 Typical High $66.07 | Professional | 53 · Discontinued | $14.13 | $37.15 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $138.04 Typical High $245.47 | Professional | 54 · Surgery only | $52.48 | $138.04 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $27.54 Typical High $48.98 | Professional | 55 · Aftercare only | $10.47 | $27.54 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $18.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $6.92 | $18.62 | $32.36 |
Where Hawaii sits
The same service costs 4.7 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· 4th of 51
$347
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.