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 $1,949.84 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,949.84 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
HMSA Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $3,467.37 | Professional | None | $2,691.53 | $3,162.28 | $3,467.37 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $1,348.96 Median $1,584.89 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $1,348.96 | $1,584.89 | $1,737.80 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $537.03 Typical High $588.84 | Professional | AS · PA/NP assist | $457.09 | $537.03 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,951.21 | Professional | None | $1,949.84 | $2,344.23 | $2,951.21 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $2,570.40 | Facility | None | $2,041.74 | $2,511.89 | $2,570.40 |
United Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $2,630.27 | Professional | None | $29.51 | $29.51 | $2,630.27 |
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 $977.24 Median $1,096.48 Typical High $1,621.81 | Professional | 52 · Reduced service | $977.24 | $1,096.48 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $436.52 Typical High $645.65 | Professional | 53 · Discontinued | $389.05 | $436.52 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,621.81 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,479.11 | $1,621.81 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $323.59 Typical High $478.63 | Professional | 55 · Aftercare only | $295.12 | $323.59 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $218.78 Typical High $323.59 | Professional | 56 · Pre-op care only | $194.98 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,513.56 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,513.56 | $2,238.72 |
Where Hawaii sits
The same service costs 5.4 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· 27th of 51
$2,692
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.