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 $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $6,456.54 | Professional | None | $1,995.26 | $1,995.26 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,096.48 | Professional | None | $524.81 | $524.81 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $2,511.89 | Facility | None | $1,148.15 | $1,202.26 | $2,511.89 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
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 $1,000.00 Median $1,000.00 Typical High $3,235.94 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $1,288.25 | Professional | 53 · Discontinued | $398.11 | $398.11 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $4,786.30 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $954.99 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $645.65 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $645.65 |
Where Hawaii sits
The same service costs 218.8 times more in Alabama than in Hawaii. 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· 51st of 51
$29.51
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.