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 $74.13 Median $144.54 Typical High $288.40 | Professional | None | $74.13 | $144.54 | $288.40 |
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 $213.80 Median $288.40 Typical High $288.40 | Professional | None | $213.80 | $288.40 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $263.03 Typical High $331.13 | Professional | None | $83.18 | $263.03 | $331.13 |
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 $107.15 Median $288.40 Typical High $288.40 | Professional | None | $107.15 | $288.40 | $288.40 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $107.15 Typical High $338.84 | Professional | None | $29.51 | $107.15 | $338.84 |
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 $37.15 Median $72.44 Typical High $131.83 | Professional | 52 · Reduced service | $37.15 | $72.44 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $28.84 Typical High $52.48 | Professional | 53 · Discontinued | $14.79 | $28.84 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $109.65 Typical High $194.98 | Professional | 54 · Surgery only | $56.23 | $109.65 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $21.88 Typical High $38.90 | Professional | 55 · Aftercare only | $11.22 | $21.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $14.45 Typical High $26.30 | Professional | 56 · Pre-op care only | $7.41 | $14.45 | $26.30 |
Where Hawaii sits
The same service costs 4.1 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· 6th of 51
$275
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.