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 $1,096.48 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,230.27 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
HMSA Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,479.11 | $1,737.80 | $1,905.46 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $870.96 Typical High $954.99 | Professional | 51 · Multiple procedures | $741.31 | $870.96 | $954.99 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $295.12 Typical High $323.59 | Professional | AS · PA/NP assist | $251.19 | $295.12 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,348.96 | $1,698.24 |
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 $1,479.11 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,479.11 | $1,479.11 | $1,548.82 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $1,071.52 Typical High $1,621.81 | Professional | None | $29.51 | $1,071.52 | $1,621.81 |
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 $549.54 Median $602.56 Typical High $933.25 | Professional | 52 · Reduced service | $549.54 | $602.56 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $245.47 Typical High $380.19 | Professional | 53 · Discontinued | $218.78 | $245.47 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $1,412.54 | Professional | 54 · Surgery only | $812.83 | $912.01 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $281.84 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $190.55 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $1,318.26 |
Where Hawaii sits
The same service costs 5.1 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· 27th of 51
$1,479
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.