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 $933.25 Median $2,818.38 Typical High $3,890.45 | Facility | None | $933.25 | $2,818.38 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $229.09 | Professional | None | $83.18 | $131.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,584.89 | Facility | None | $977.24 | $1,096.48 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | None | $186.21 | $229.09 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $208.93 Typical High $257.04 | Professional | None | $93.33 | $208.93 | $257.04 |
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 $123.03 Median $229.09 Typical High $229.09 | Professional | None | $123.03 | $229.09 | $229.09 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $123.03 Typical High $263.03 | Professional | None | $29.51 | $123.03 | $263.03 |
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 $41.69 Median $66.07 Typical High $104.71 | Professional | 52 · Reduced service | $41.69 | $66.07 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.30 Typical High $41.69 | Professional | 53 · Discontinued | $16.60 | $26.30 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $100.00 Typical High $154.88 | Professional | 54 · Surgery only | $63.10 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.95 Typical High $31.62 | Professional | 55 · Aftercare only | $12.59 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.18 Typical High $20.89 | Professional | 56 · Pre-op care only | $8.32 | $13.18 | $20.89 |
Where Hawaii sits
The same service costs 3.6 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
$229
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.