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 $562,341.33 Median $562,341.33 Typical High $616,595.00 | Professional | None | $562,341.33 | $562,341.33 | $616,595.00 |
HMSA Setting Professional Modifier None Typical Low $562,341.33 Median $562,341.33 Typical High $562,341.33 | Professional | None | $562,341.33 | $562,341.33 | $562,341.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537,031.80 Median $630,957.34 Typical High $794,328.23 | Professional | None | $537,031.80 | $630,957.34 | $794,328.23 |
United Setting Professional Modifier None Typical Low $537,031.80 Median $537,031.80 Typical High $537,031.80 | Professional | None | $537,031.80 | $537,031.80 | $537,031.80 |
University Health Alliance Setting Professional Modifier None Typical Low $630,957.34 Median $630,957.34 Typical High $794,328.23 | Professional | None | $630,957.34 | $630,957.34 | $794,328.23 |
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 $281,838.29 Median $281,838.29 Typical High $309,029.54 | Professional | 52 · Reduced service | $281,838.29 | $281,838.29 | $309,029.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112,201.85 Median $112,201.85 Typical High $123,026.88 | Professional | 53 · Discontinued | $112,201.85 | $112,201.85 | $123,026.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85,113.80 Median $85,113.80 Typical High $93,325.43 | Professional | 55 · Aftercare only | $85,113.80 | $85,113.80 | $93,325.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56,234.13 Median $56,234.13 Typical High $61,659.50 | Professional | 56 · Pre-op care only | $56,234.13 | $56,234.13 | $61,659.50 |
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· 46th of 51
$562,341
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.