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 $154.88 Typical High $218.78 | Professional | None | $102.33 | $154.88 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $234.42 | Professional | None | $190.55 | $234.42 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $251.19 | Professional | None | $109.65 | $199.53 | $251.19 |
United Setting Facility Modifier None Typical Low $269.15 Median $616.60 Typical High $1,122.02 | Facility | None | $269.15 | $616.60 | $1,122.02 |
United Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $234.42 | Professional | None | $141.25 | $234.42 | $234.42 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $100.00 Typical High $257.04 | Professional | None | $29.51 | $100.00 | $257.04 |
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 $50.12 Median $75.86 Typical High $107.15 | Professional | 52 · Reduced service | $50.12 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $30.90 Typical High $43.65 | Professional | 53 · Discontinued | $20.42 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $114.82 Typical High $162.18 | Professional | 54 · Surgery only | $75.86 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $22.91 Typical High $32.36 | Professional | 55 · Aftercare only | $15.14 | $22.91 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.23 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $107.15 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $70.79 | $107.15 | $151.36 |
Where Hawaii sits
The same service costs 3.5 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· 14th of 51
$229
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.