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 $123.03 Median $407.38 Typical High $630.96 | Professional | None | $123.03 | $407.38 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | None | $537.03 | $645.65 | $645.65 |
HMSA Setting Professional Modifier None Typical Low $288.40 Median $812.83 Typical High $870.96 | Professional | None | $288.40 | $812.83 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $524.81 Typical High $645.65 | Professional | None | $125.89 | $524.81 | $645.65 |
United Setting Facility Modifier None Typical Low $269.15 Median $616.60 Typical High $1,122.02 | Facility | None | $269.15 | $616.60 | $1,122.02 |
United Setting Professional Modifier None Typical Low $181.97 Median $645.65 Typical High $645.65 | Professional | None | $181.97 | $645.65 | $645.65 |
University Health Alliance Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $758.58 | Professional | None | $117.49 | $173.78 | $758.58 |
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 $61.66 Median $204.17 Typical High $316.23 | Professional | 52 · Reduced service | $61.66 | $204.17 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $83.18 Typical High $125.89 | Professional | 53 · Discontinued | $24.55 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $309.03 Typical High $478.63 | Professional | 54 · Surgery only | $93.33 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $61.66 Typical High $95.50 | Professional | 55 · Aftercare only | $18.62 | $61.66 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $40.74 Typical High $63.10 | Professional | 56 · Pre-op care only | $12.30 | $40.74 | $63.10 |
Where Hawaii sits
The same service costs 4.9 times more in Iowa than in Maryland. 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· 5th of 51
$646
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.