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 $288.40 Median $389.05 Typical High $1,258.93 | Professional | None | $288.40 | $389.05 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $537.03 Typical High $891.25 | Professional | None | $229.09 | $537.03 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $316.23 | Professional | None | $208.93 | $251.19 | $316.23 |
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 |
United Setting Professional Modifier None Typical Low $426.58 Median $831.76 Typical High $831.76 | Professional | None | $426.58 | $831.76 | $831.76 |
University Health Alliance Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | None | $223.87 | $251.19 | $251.19 |
3 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 54 · Surgery only Typical Low $218.78 Median $288.40 Typical High $933.25 | Professional | 54 · Surgery only | $218.78 | $288.40 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $57.54 Typical High $186.21 | Professional | 55 · Aftercare only | $43.65 | $57.54 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.02 Typical High $125.89 | Professional | 56 · Pre-op care only | $28.84 | $38.02 | $125.89 |
Where Hawaii sits
The same service costs 15.1 times more in New York 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
$251
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.