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 $3,890.45 Median $3,981.07 Typical High $4,073.80 | Professional | None | $3,890.45 | $3,981.07 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
HMSA Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $676.08 | Professional | None | $5.01 | $5.01 | $676.08 |
United Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
University Health Alliance Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
4 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 $1,949.84 Median $1,995.26 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,949.84 | $1,995.26 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $794.33 Typical High $812.83 | Professional | 53 · Discontinued | $776.25 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $602.56 Typical High $616.60 | Professional | 55 · Aftercare only | $575.44 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $398.11 Typical High $407.38 | Professional | 56 · Pre-op care only | $389.05 | $398.11 | $407.38 |
Where Hawaii sits
The same service costs 1.5 times more in Alaska than in Idaho. 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
$5,754
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.