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 $1,412.54 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,584.89 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
HMSA Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,630.27 | Professional | None | $2,041.74 | $2,398.83 | $2,630.27 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,202.26 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $1,023.29 | $1,202.26 | $1,318.26 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $407.38 Typical High $446.68 | Professional | AS · PA/NP assist | $346.74 | $407.38 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,698.24 | $2,137.96 |
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 $1,819.70 Median $1,819.70 Typical High $1,949.84 | Professional | None | $1,819.70 | $1,819.70 | $1,949.84 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $1,348.96 Typical High $2,041.74 | Professional | None | $29.51 | $1,348.96 | $2,041.74 |
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 $707.95 Median $794.33 Typical High $1,230.27 | Professional | 52 · Reduced service | $707.95 | $794.33 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $489.78 | Professional | 53 · Discontinued | $281.84 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $371.54 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $245.47 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,737.80 |
Where Hawaii sits
The same service costs 5.4 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· 29th of 51
$2,042
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.