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 $416,869.38 Median $512,861.38 Typical High $562,341.33 | Professional | None | $416,869.38 | $512,861.38 | $562,341.33 |
HMSA Setting Professional Modifier None Typical Low $512,861.38 Median $512,861.38 Typical High $512,861.38 | Professional | None | $512,861.38 | $512,861.38 | $512,861.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489,778.82 Median $588,843.66 Typical High $741,310.24 | Professional | None | $489,778.82 | $588,843.66 | $741,310.24 |
United Setting Professional Modifier None Typical Low $489,778.82 Median $489,778.82 Typical High $489,778.82 | Professional | None | $489,778.82 | $489,778.82 | $489,778.82 |
University Health Alliance Setting Professional Modifier None Typical Low $630,957.34 Median $630,957.34 Typical High $724,435.96 | Professional | None | $630,957.34 | $630,957.34 | $724,435.96 |
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 $208,929.61 Median $257,039.58 Typical High $281,838.29 | Professional | 52 · Reduced service | $208,929.61 | $257,039.58 | $281,838.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83,176.38 Median $102,329.30 Typical High $112,201.85 | Professional | 53 · Discontinued | $83,176.38 | $102,329.30 | $112,201.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63,095.73 Median $75,857.76 Typical High $85,113.80 | Professional | 55 · Aftercare only | $63,095.73 | $75,857.76 | $85,113.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41,686.94 Median $51,286.14 Typical High $56,234.13 | Professional | 56 · Pre-op care only | $41,686.94 | $51,286.14 | $56,234.13 |
Where Hawaii sits
The same service costs 2.0 times more in Texas than in New Jersey. 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· 38th of 51
$512,861
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.