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 $1,479.11 Median $2,818.38 Typical High $6,025.60 | Facility | None | $1,479.11 | $2,818.38 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,659.59 | Professional | None | $977.24 | $1,096.48 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $2,570.40 | Facility | None | $1,548.82 | $1,737.80 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,479.11 | Professional | None | $977.24 | $1,174.90 | $1,479.11 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $5,754.40 | Facility | None | $3,019.95 | $3,548.13 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $181.97 Typical High $1,445.44 | Professional | None | $29.51 | $181.97 | $1,445.44 |
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 $489.78 Median $537.03 Typical High $812.83 | Professional | 52 · Reduced service | $489.78 | $537.03 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $218.78 Typical High $323.59 | Professional | 53 · Discontinued | $194.98 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $1,230.27 | Professional | 54 · Surgery only | $724.44 | $812.83 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $245.47 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $162.18 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $1,148.15 |
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· 27th of 51
$1,349
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.