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 $3,981.07 Median $4,677.35 Typical High $7,079.46 | Professional | None | $3,981.07 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
HMSA Setting Professional Modifier None Typical Low $5,370.32 Median $6,309.57 Typical High $6,918.31 | Professional | None | $5,370.32 | $6,309.57 | $6,918.31 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $2,691.53 Median $3,162.28 Typical High $3,467.37 | Professional | 51 · Multiple procedures | $2,691.53 | $3,162.28 | $3,467.37 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $912.01 Median $1,071.52 Typical High $1,174.90 | Professional | AS · PA/NP assist | $912.01 | $1,071.52 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,981.07 Median $4,786.30 Typical High $6,025.60 | Professional | None | $3,981.07 | $4,786.30 | $6,025.60 |
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 $5,248.07 Median $5,248.07 Typical High $5,495.41 | Professional | None | $5,248.07 | $5,248.07 | $5,495.41 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $3,890.45 Typical High $5,754.40 | Professional | None | $29.51 | $3,890.45 | $5,754.40 |
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 $1,995.26 Median $2,290.87 Typical High $3,548.13 | Professional | 52 · Reduced service | $1,995.26 | $2,290.87 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $933.25 Typical High $1,412.54 | Professional | 53 · Discontinued | $794.33 | $933.25 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,467.37 Typical High $5,248.07 | Professional | 54 · Surgery only | $2,951.21 | $3,467.37 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $691.83 Typical High $1,047.13 | Professional | 55 · Aftercare only | $588.84 | $691.83 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $467.74 Typical High $707.95 | Professional | 56 · Pre-op care only | $398.11 | $467.74 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,235.94 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,235.94 | $4,897.79 |
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· 25th of 51
$5,370
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.