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 $2,089.30 Median $3,162.28 Typical High $8,511.38 | Facility | None | $2,089.30 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,071.52 | Professional | None | $645.65 | $741.31 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $3,467.37 | Facility | None | $2,187.76 | $2,454.71 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,000.00 | Professional | None | $660.69 | $794.33 | $1,000.00 |
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 $870.96 Median $891.25 Typical High $891.25 | Professional | None | $870.96 | $891.25 | $891.25 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $120.23 Typical High $954.99 | Professional | None | $29.51 | $120.23 | $954.99 |
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 $323.59 Median $363.08 Typical High $537.03 | Professional | 52 · Reduced service | $323.59 | $363.08 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $213.80 | Professional | 53 · Discontinued | $128.82 | $144.54 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $794.33 | Professional | 54 · Surgery only | $478.63 | $537.03 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $107.15 Typical High $158.49 | Professional | 55 · Aftercare only | $95.50 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $107.15 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $741.31 |
Where Hawaii sits
The same service costs 6.3 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· 28th of 51
$891
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.