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 $933.25 Median $2,818.38 Typical High $3,890.45 | Facility | None | $933.25 | $2,818.38 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,096.48 | Professional | None | $691.83 | $776.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,584.89 | Facility | None | $977.24 | $1,096.48 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
HMSA Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,258.93 | Professional | None | $977.24 | $1,148.15 | $1,258.93 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $575.44 Typical High $630.96 | Professional | 51 · Multiple procedures | $489.78 | $575.44 | $630.96 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $213.80 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,096.48 | Professional | None | $741.31 | $891.25 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,737.80 | Facility | None | $1,202.26 | $1,380.38 | $1,737.80 |
United Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | None | $954.99 | $977.24 | $977.24 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $954.99 Typical High $1,071.52 | Professional | None | $29.51 | $954.99 | $1,071.52 |
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 $346.74 Median $389.05 Typical High $549.54 | Professional | 52 · Reduced service | $346.74 | $389.05 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $218.78 | Professional | 53 · Discontinued | $138.04 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $831.76 | Professional | 54 · Surgery only | $512.86 | $575.44 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $165.96 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $109.65 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $776.25 |
Where Hawaii sits
The same service costs 4.7 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
$977
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.