How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,570.40 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
HMSA Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,454.71 | $2,951.21 | $3,630.78 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,884.03 | $2,884.03 |
University Health Alliance Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,344.23 | $3,162.28 |
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 $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 53 · Discontinued | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $281.84 |
Where Hawaii sits
Rates are fairly even across states for this service. 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· 2nd of 51
$2,884
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.