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 $870.96 Median $977.24 Typical High $1,412.54 | Professional | None | $870.96 | $977.24 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
HMSA Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,445.44 | $1,584.89 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $724.44 Typical High $794.33 | Professional | 51 · Multiple procedures | $616.60 | $724.44 | $794.33 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $245.47 Typical High $269.15 | Professional | AS · PA/NP assist | $208.93 | $245.47 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,412.54 | Professional | None | $954.99 | $1,148.15 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $2,511.89 | Facility | None | $1,148.15 | $1,202.26 | $2,511.89 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,202.26 | $1,258.93 | $1,258.93 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $891.25 Typical High $1,348.96 | Professional | None | $29.51 | $891.25 | $1,348.96 |
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 $436.52 Median $489.78 Typical High $707.95 | Professional | 52 · Reduced service | $436.52 | $489.78 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $281.84 | Professional | 53 · Discontinued | $173.78 | $194.98 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $741.31 Typical High $1,071.52 | Professional | 54 · Surgery only | $660.69 | $741.31 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $213.80 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $141.25 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $691.83 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $616.60 | $691.83 | $1,000.00 |
Where Hawaii sits
The same service costs 25.1 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· 22nd of 51
$1,259
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.