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 $478,630.09 Median $575,439.94 Typical High $630,957.34 | Professional | None | $478,630.09 | $575,439.94 | $630,957.34 |
HMSA Setting Professional Modifier None Typical Low $575,439.94 Median $575,439.94 Typical High $575,439.94 | Professional | None | $575,439.94 | $575,439.94 | $575,439.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562,341.33 Median $676,082.98 Typical High $851,138.04 | Professional | None | $562,341.33 | $676,082.98 | $851,138.04 |
United 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 |
University Health Alliance Setting Professional Modifier None Typical Low $660,693.45 Median $660,693.45 Typical High $831,763.77 | Professional | None | $660,693.45 | $660,693.45 | $831,763.77 |
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 $239,883.29 Median $288,403.15 Typical High $316,227.77 | Professional | 52 · Reduced service | $239,883.29 | $288,403.15 | $316,227.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95,499.26 Median $114,815.36 Typical High $128,824.96 | Professional | 53 · Discontinued | $95,499.26 | $114,815.36 | $128,824.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72,443.60 Median $87,096.36 Typical High $95,499.26 | Professional | 55 · Aftercare only | $72,443.60 | $87,096.36 | $95,499.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47,863.01 Median $57,543.99 Typical High $63,095.73 | Professional | 56 · Pre-op care only | $47,863.01 | $57,543.99 | $63,095.73 |
Where Hawaii sits
The same service costs 1.7 times more in Texas than in Minnesota. 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· 42nd of 51
$575,440
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.