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 $2,570.40 Median $3,235.94 Typical High $5,370.32 | Professional | None | $2,570.40 | $3,235.94 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
HMSA Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $5,248.07 | Professional | None | $4,073.80 | $4,786.30 | $5,248.07 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $2,041.74 Median $2,398.83 Typical High $2,630.27 | Professional | 51 · Multiple procedures | $2,041.74 | $2,398.83 | $2,630.27 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $691.83 Median $812.83 Typical High $891.25 | Professional | AS · PA/NP assist | $691.83 | $812.83 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,090.30 Median $3,715.35 Typical High $4,570.88 | Professional | None | $3,090.30 | $3,715.35 | $4,570.88 |
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 $3,981.07 Median $3,981.07 Typical High $4,265.80 | Professional | None | $3,981.07 | $3,981.07 | $4,265.80 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $2,290.87 Typical High $4,466.84 | Professional | None | $29.51 | $2,290.87 | $4,466.84 |
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 $1,288.25 Median $1,621.81 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,288.25 | $1,621.81 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $645.65 Typical High $1,071.52 | Professional | 53 · Discontinued | $512.86 | $645.65 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,454.71 Typical High $4,073.80 | Professional | 54 · Surgery only | $1,949.84 | $2,454.71 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $489.78 Typical High $812.83 | Professional | 55 · Aftercare only | $389.05 | $489.78 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $323.59 Typical High $537.03 | Professional | 56 · Pre-op care only | $257.04 | $323.59 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,290.87 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,290.87 | $3,801.89 |
Where Hawaii sits
The same service costs 21.9 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
$4,169
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.