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 $102.33 Median $138.04 Typical High $213.80 | Professional | None | $102.33 | $138.04 | $213.80 |
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 $181.97 Median $190.55 Typical High $190.55 | Professional | None | $181.97 | $190.55 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $208.93 | Professional | None | $117.49 | $165.96 | $208.93 |
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 $138.04 Median $190.55 Typical High $190.55 | Professional | None | $138.04 | $190.55 | $190.55 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $134.90 Typical High $208.93 | Professional | None | $29.51 | $134.90 | $208.93 |
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 $67.61 Typical High $93.33 | Professional | 52 · Reduced service | $51.29 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $37.15 | Professional | 53 · Discontinued | $20.42 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $100.00 Typical High $141.25 | Professional | 54 · Surgery only | $77.62 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.95 Typical High $28.18 | Professional | 55 · Aftercare only | $15.49 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $93.33 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $72.44 | $93.33 | $131.83 |
Where Hawaii sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 15th of 51
$186
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.