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 $1,318.26 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,318.26 | $2,818.38 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $363.08 | Professional | None | $194.98 | $223.87 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,290.87 | Facility | None | $1,380.38 | $1,548.82 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $302.00 | Professional | None | $204.17 | $245.47 | $302.00 |
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 $269.15 Median $275.42 Typical High $275.42 | Professional | None | $269.15 | $275.42 | $275.42 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $263.03 Typical High $295.12 | Professional | None | $29.51 | $263.03 | $295.12 |
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 $95.50 Median $107.15 Typical High $151.36 | Professional | 52 · Reduced service | $95.50 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $42.66 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $141.25 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.38 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.05 | $21.38 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $213.80 |
Where Hawaii sits
The same service costs 5.6 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· 26th of 51
$275
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.