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 $501.19 Median $562.34 Typical High $851.14 | Professional | None | $501.19 | $562.34 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
HMSA Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $891.25 | Professional | None | $691.83 | $812.83 | $891.25 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $346.74 Median $407.38 Typical High $446.68 | Professional | 51 · Multiple procedures | $346.74 | $407.38 | $446.68 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $151.36 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $831.76 | Professional | None | $549.54 | $660.69 | $831.76 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $512.86 Typical High $758.58 | Professional | None | $29.51 | $512.86 | $758.58 |
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 $245.47 Median $281.84 Typical High $426.58 | Professional | 52 · Reduced service | $245.47 | $281.84 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $169.82 | Professional | 53 · Discontinued | $100.00 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $630.96 | Professional | 54 · Surgery only | $371.54 | $426.58 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $128.82 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $85.11 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $588.84 |
Where Hawaii sits
The same service costs 5.5 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· 27th of 51
$708
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.