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 $741.31 Median $831.76 Typical High $1,288.25 | Professional | None | $741.31 | $831.76 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,174.90 | Professional | None | $776.25 | $933.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $2,570.40 | Facility | None | $2,041.74 | $2,511.89 | $2,570.40 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,047.13 | Professional | None | $1,023.29 | $1,023.29 | $1,047.13 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $741.31 Typical High $1,096.48 | Professional | None | $29.51 | $741.31 | $1,096.48 |
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 $371.54 Median $416.87 Typical High $645.65 | Professional | 52 · Reduced service | $371.54 | $416.87 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $257.04 | Professional | 53 · Discontinued | $147.91 | $165.96 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $977.24 | Professional | 54 · Surgery only | $562.34 | $630.96 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $194.98 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $128.82 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $912.01 |
Where Hawaii sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$1,023
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.