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 $2,884.03 Median $2,951.21 Typical High $3,981.07 | Professional | None | $2,884.03 | $2,951.21 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
HMSA Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $4,265.80 | Professional | None | $2,818.38 | $3,388.44 | $4,265.80 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,818.38 | $3,162.28 | $3,162.28 |
University Health Alliance Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,754.23 | $3,162.28 | $4,168.69 |
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 $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 53 · Discontinued | $575.44 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $316.23 |
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· 8th of 51
$3,162
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.