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 $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,348.96 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,380.38 | $1,737.80 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $2,570.40 | Facility | None | $2,041.74 | $2,511.89 | $2,570.40 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,698.24 | Professional | None | $1,659.59 | $1,659.59 | $1,698.24 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $229.09 Typical High $1,819.70 | Professional | None | $29.51 | $229.09 | $1,819.70 |
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 $616.60 Median $676.08 Typical High $1,000.00 | Professional | 52 · Reduced service | $616.60 | $676.08 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $407.38 | Professional | 53 · Discontinued | $245.47 | $269.15 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,513.56 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $302.00 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $199.53 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $954.99 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $851.14 | $954.99 | $1,412.54 |
Where Hawaii sits
The same service costs 6.8 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
$1,660
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.