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 $933.25 Median $2,818.38 Typical High $3,890.45 | Facility | None | $933.25 | $2,818.38 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $436.52 | Professional | None | $213.80 | $275.42 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,584.89 | Facility | None | $977.24 | $1,096.48 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | None | $371.54 | $398.11 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $407.38 | Professional | None | $229.09 | $331.13 | $407.38 |
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 $288.40 Median $398.11 Typical High $398.11 | Professional | None | $288.40 | $398.11 | $398.11 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $204.17 Typical High $426.58 | Professional | None | $29.51 | $204.17 | $426.58 |
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 $104.71 Median $138.04 Typical High $190.55 | Professional | 52 · Reduced service | $104.71 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $54.95 Typical High $75.86 | Professional | 53 · Discontinued | $42.66 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $208.93 Typical High $288.40 | Professional | 54 · Surgery only | $158.49 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $41.69 Typical High $57.54 | Professional | 55 · Aftercare only | $31.62 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $27.54 Typical High $38.02 | Professional | 56 · Pre-op care only | $21.38 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $194.98 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $147.91 | $194.98 | $269.15 |
Where Hawaii sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$389
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.