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 $218.78 Median $257.04 Typical High $371.54 | Professional | None | $218.78 | $257.04 | $371.54 |
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 $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $346.74 | Professional | None | $229.09 | $275.42 | $346.74 |
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 $309.03 Median $316.23 Typical High $316.23 | Professional | None | $309.03 | $316.23 | $316.23 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $302.00 Typical High $331.13 | Professional | None | $29.51 | $302.00 | $331.13 |
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 $109.65 Median $123.03 Typical High $177.83 | Professional | 52 · Reduced service | $109.65 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $48.98 Typical High $70.79 | Professional | 53 · Discontinued | $44.67 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $181.97 Typical High $269.15 | Professional | 54 · Surgery only | $165.96 | $181.97 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $36.31 Typical High $53.70 | Professional | 55 · Aftercare only | $33.11 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $24.55 Typical High $35.48 | Professional | 56 · Pre-op care only | $21.88 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $169.82 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $154.88 | $169.82 | $251.19 |
Where Hawaii sits
The same service costs 6.0 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· 28th of 51
$316
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.