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 $389.05 Median $457.09 Typical High $676.08 | Professional | None | $389.05 | $457.09 | $676.08 |
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 $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
HMSA Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $776.25 | Professional | None | $602.56 | $707.95 | $776.25 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $346.74 Typical High $389.05 | Professional | 51 · Multiple procedures | $295.12 | $346.74 | $389.05 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $131.83 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $691.83 | Professional | None | $467.74 | $562.34 | $691.83 |
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 $562.34 Median $602.56 Typical High $602.56 | Professional | None | $562.34 | $602.56 | $602.56 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $660.69 | Professional | None | $29.51 | $29.51 | $660.69 |
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 $194.98 Median $229.09 Typical High $338.84 | Professional | 52 · Reduced service | $194.98 | $229.09 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $91.20 Typical High $134.90 | Professional | 53 · Discontinued | $77.62 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $346.74 Typical High $501.19 | Professional | 54 · Surgery only | $295.12 | $346.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $69.18 Typical High $100.00 | Professional | 55 · Aftercare only | $58.88 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $67.61 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $323.59 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $275.42 | $323.59 | $467.74 |
Where Hawaii sits
The same service costs 6.2 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· 20th of 51
$603
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.