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 $630.96 Median $707.95 Typical High $1,047.13 | Professional | None | $630.96 | $707.95 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
HMSA Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,096.48 | Professional | None | $851.14 | $1,000.00 | $1,096.48 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $501.19 Typical High $549.54 | Professional | 51 · Multiple procedures | $426.58 | $501.19 | $549.54 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $186.21 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,000.00 | Professional | None | $676.08 | $812.83 | $1,000.00 |
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 $851.14 Median $851.14 Typical High $891.25 | Professional | None | $851.14 | $851.14 | $891.25 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $117.49 Typical High $933.25 | Professional | None | $29.51 | $117.49 | $933.25 |
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 $316.23 Median $346.74 Typical High $537.03 | Professional | 52 · Reduced service | $316.23 | $346.74 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $213.80 | Professional | 53 · Discontinued | $125.89 | $138.04 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $812.83 | Professional | 54 · Surgery only | $467.74 | $524.81 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $162.18 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $107.15 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $758.58 |
Where Hawaii sits
The same service costs 4.5 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· 31st of 51
$851
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.