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 $1,000.00 Median $2,884.03 Typical High $2,884.03 | Facility | None | $1,000.00 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $363.08 | Professional | None | $177.83 | $263.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $407.38 | Professional | None | $331.13 | $407.38 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $436.52 | Professional | None | $229.09 | $354.81 | $436.52 |
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 $245.47 Median $407.38 Typical High $407.38 | Professional | None | $245.47 | $407.38 | $407.38 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $58.88 Typical High $416.87 | Professional | None | $29.51 | $58.88 | $416.87 |
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 $89.13 Median $128.82 Typical High $181.97 | Professional | 52 · Reduced service | $89.13 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $52.48 Typical High $72.44 | Professional | 53 · Discontinued | $35.48 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $194.98 Typical High $269.15 | Professional | 54 · Surgery only | $134.90 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.90 Typical High $54.95 | Professional | 55 · Aftercare only | $26.92 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $26.30 Typical High $36.31 | Professional | 56 · Pre-op care only | $17.78 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $181.97 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $125.89 | $181.97 | $251.19 |
Where Hawaii sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 16th of 51
$347
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.