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 $1,348.96 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,513.56 | $2,344.23 |
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 $1,819.70 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,819.70 | $2,137.96 | $2,344.23 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $1,071.52 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $912.01 | $1,071.52 | $1,174.90 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $363.08 Typical High $398.11 | Professional | AS · PA/NP assist | $309.03 | $363.08 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,659.59 | $2,089.30 |
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 $1,905.46 | Professional | None | $1,819.70 | $1,819.70 | $1,905.46 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $1,348.96 Typical High $1,995.26 | Professional | None | $29.51 | $1,348.96 | $1,995.26 |
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 $676.08 Median $758.58 Typical High $1,174.90 | Professional | 52 · Reduced service | $676.08 | $758.58 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $467.74 | Professional | 53 · Discontinued | $269.15 | $302.00 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $354.81 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $151.36 Typical High $234.42 | Professional | 56 · Pre-op care only | $134.90 | $151.36 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,659.59 |
Where Hawaii sits
The same service costs 20.9 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· 28th of 51
$1,820
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.