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 $1,047.13 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,174.90 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
HMSA Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,698.24 | $1,862.09 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $851.14 Typical High $933.25 | Professional | 51 · Multiple procedures | $724.44 | $851.14 | $933.25 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $316.23 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
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 $1,445.44 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,445.44 | $1,479.11 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $1,047.13 Typical High $1,584.89 | Professional | None | $29.51 | $1,047.13 | $1,584.89 |
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 $524.81 Median $588.84 Typical High $912.01 | Professional | 52 · Reduced service | $524.81 | $588.84 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $234.42 Typical High $363.08 | Professional | 53 · Discontinued | $208.93 | $234.42 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $891.25 Typical High $1,348.96 | Professional | 54 · Surgery only | $794.33 | $891.25 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $177.83 Typical High $275.42 | Professional | 55 · Aftercare only | $158.49 | $177.83 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $117.49 Typical High $181.97 | Professional | 56 · Pre-op care only | $104.71 | $117.49 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $831.76 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $741.31 | $831.76 | $1,258.93 |
Where Hawaii sits
The same service costs 22.4 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· 26th of 51
$1,445
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.