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 $2,570.40 Median $6,025.60 Typical High $6,025.60 | Facility | None | $2,570.40 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,174.90 | Professional | None | $676.08 | $758.58 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
HMSA Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,202.26 | Professional | None | $933.25 | $1,096.48 | $1,202.26 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $549.54 Typical High $602.56 | Professional | 51 · Multiple procedures | $467.74 | $549.54 | $602.56 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $204.17 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,071.52 | Professional | None | $724.44 | $870.96 | $1,071.52 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $7,079.46 | Facility | None | $3,090.30 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | None | $933.25 | $933.25 | $954.99 |
University Health Alliance Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | None | $912.01 | $1,023.29 | $1,023.29 |
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 $338.84 Median $380.19 Typical High $588.84 | Professional | 52 · Reduced service | $338.84 | $380.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $151.36 Typical High $234.42 | Professional | 53 · Discontinued | $134.90 | $151.36 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $891.25 | Professional | 54 · Surgery only | $512.86 | $575.44 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $177.83 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $117.49 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $831.76 |
Where Hawaii sits
The same service costs 25.1 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
$1,000
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.