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 $691.83 Median $2,818.38 Typical High $2,884.03 | Facility | None | $691.83 | $2,818.38 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $316.23 | Professional | None | $102.33 | $190.55 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,174.90 | Facility | None | $724.44 | $812.83 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | None | $234.42 | $281.84 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $288.40 | Professional | None | $120.23 | $229.09 | $288.40 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,737.80 | Facility | None | $1,202.26 | $1,380.38 | $1,737.80 |
United Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $281.84 | Professional | None | $144.54 | $281.84 | $281.84 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $151.36 Typical High $302.00 | Professional | None | $29.51 | $151.36 | $302.00 |
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 $51.29 Median $91.20 Typical High $125.89 | Professional | 52 · Reduced service | $51.29 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $36.31 Typical High $51.29 | Professional | 53 · Discontinued | $20.42 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $138.04 Typical High $190.55 | Professional | 54 · Surgery only | $75.86 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $27.54 Typical High $38.02 | Professional | 55 · Aftercare only | $15.14 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $18.20 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.23 | $18.20 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $128.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $70.79 | $128.82 | $177.83 |
Where Hawaii sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 13th of 51
$245
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.