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 $66.07 Median $489.78 Typical High $776.25 | Professional | None | $66.07 | $489.78 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $758.58 | Professional | None | $588.84 | $758.58 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $616.60 Typical High $741.31 | Professional | None | $66.07 | $616.60 | $741.31 |
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 $95.50 Median $758.58 Typical High $758.58 | Professional | None | $95.50 | $758.58 | $758.58 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $95.50 Typical High $870.96 | Professional | None | $29.51 | $95.50 | $870.96 |
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 $33.11 Median $239.88 Typical High $363.08 | Professional | 52 · Reduced service | $33.11 | $239.88 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $97.72 Typical High $144.54 | Professional | 53 · Discontinued | $13.49 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $363.08 Typical High $549.54 | Professional | 54 · Surgery only | $50.12 | $363.08 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $72.44 Typical High $109.65 | Professional | 55 · Aftercare only | $10.00 | $72.44 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $48.98 Typical High $72.44 | Professional | 56 · Pre-op care only | $6.61 | $48.98 | $72.44 |
Where Hawaii sits
The same service costs 8.9 times more in Iowa 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· 7th of 51
$676
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.