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 $1,047.13 Median $2,818.38 Typical High $4,466.84 | Facility | None | $1,047.13 | $2,818.38 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $489.78 | Professional | None | $263.03 | $309.03 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,819.70 | Facility | None | $1,122.02 | $1,258.93 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $398.11 | Professional | None | $269.15 | $323.59 | $398.11 |
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 $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $354.81 Typical High $398.11 | Professional | None | $29.51 | $354.81 | $398.11 |
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 $131.83 Median $144.54 Typical High $213.80 | Professional | 52 · Reduced service | $131.83 | $144.54 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $85.11 | Professional | 53 · Discontinued | $52.48 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $323.59 | Professional | 54 · Surgery only | $199.53 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $64.57 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $42.66 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $186.21 | $204.17 | $302.00 |
Where Hawaii sits
The same service costs 5.5 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· 31st of 51
$372
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.