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 $1,513.56 Median $3,890.45 Typical High $3,890.45 | Facility | None | $1,513.56 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $389.05 | Professional | None | $158.49 | $245.47 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | None | $309.03 | $331.13 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $354.81 | Professional | None | $169.82 | $281.84 | $354.81 |
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 $218.78 Median $331.13 Typical High $331.13 | Professional | None | $218.78 | $331.13 | $331.13 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $151.36 Typical High $371.54 | Professional | None | $29.51 | $151.36 | $371.54 |
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 $79.43 Median $117.49 Typical High $162.18 | Professional | 52 · Reduced service | $79.43 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $46.77 Typical High $64.57 | Professional | 53 · Discontinued | $31.62 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $173.78 Typical High $245.47 | Professional | 54 · Surgery only | $117.49 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $34.67 Typical High $48.98 | Professional | 55 · Aftercare only | $23.99 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.44 Typical High $32.36 | Professional | 56 · Pre-op care only | $15.85 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $229.09 |
Where Hawaii sits
The same service costs 3.6 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· 14th of 51
$331
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.