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 $891.25 Median $1,047.13 Typical High $1,548.82 | Professional | None | $891.25 | $1,047.13 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
HMSA Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,479.11 | $1,621.81 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $741.31 Typical High $812.83 | Professional | 51 · Multiple procedures | $630.96 | $741.31 | $812.83 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $251.19 Typical High $275.42 | Professional | AS · PA/NP assist | $213.80 | $251.19 | $275.42 |
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 $1,202.26 Typical High $1,258.93 | Professional | None | $1,202.26 | $1,202.26 | $1,258.93 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $851.14 Typical High $1,318.26 | Professional | None | $29.51 | $851.14 | $1,318.26 |
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 $446.68 Median $524.81 Typical High $776.25 | Professional | 52 · Reduced service | $446.68 | $524.81 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $208.93 Typical High $316.23 | Professional | 53 · Discontinued | $177.83 | $208.93 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $776.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $660.69 | $776.25 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $154.88 Typical High $234.42 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $104.71 Typical High $154.88 | Professional | 56 · Pre-op care only | $89.13 | $104.71 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $724.44 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $616.60 | $724.44 | $1,096.48 |
Where Hawaii sits
The same service costs 24.5 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· 28th 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.