How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,621.81 | Professional | None | $977.24 | $1,148.15 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
HMSA Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,621.81 | $1,778.28 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $812.83 Typical High $891.25 | Professional | 51 · Multiple procedures | $691.83 | $812.83 | $891.25 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $275.42 Typical High $302.00 | Professional | AS · PA/NP assist | $234.42 | $275.42 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,258.93 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $2,511.89 | Facility | None | $1,148.15 | $1,202.26 | $2,511.89 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,412.54 | Professional | None | $1,380.38 | $1,380.38 | $1,412.54 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $190.55 Typical High $1,513.56 | Professional | None | $29.51 | $190.55 | $1,513.56 |
6 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 $457.09 Median $562.34 Typical High $831.76 | Professional | 52 · Reduced service | $457.09 | $562.34 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $223.87 Typical High $331.13 | Professional | 53 · Discontinued | $186.21 | $223.87 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $831.76 Typical High $1,230.27 | Professional | 54 · Surgery only | $691.83 | $831.76 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $165.96 Typical High $245.47 | Professional | 55 · Aftercare only | $138.04 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $112.20 Typical High $165.96 | Professional | 56 · Pre-op care only | $93.33 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $776.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $645.65 | $776.25 | $1,148.15 |
Where Hawaii sits
The same service costs 19.5 times more in Alaska than in Texas. 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· 28th of 51
$1,380
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.