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 $6,918.31 Typical High $6,918.31 | Facility | None | $2,818.38 | $6,918.31 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,318.26 | Professional | None | $776.25 | $851.14 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
HMSA Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,230.27 | $1,348.96 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $616.60 Typical High $676.08 | Professional | 51 · Multiple procedures | $524.81 | $616.60 | $676.08 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $208.93 Typical High $229.09 | Professional | AS · PA/NP assist | $177.83 | $208.93 | $229.09 |
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 $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 $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | None | $1,047.13 | $1,047.13 | $1,071.52 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $144.54 Typical High $1,148.15 | Professional | None | $29.51 | $144.54 | $1,148.15 |
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 $380.19 Median $426.58 Typical High $660.69 | Professional | 52 · Reduced service | $380.19 | $426.58 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $263.03 | Professional | 53 · Discontinued | $154.88 | $169.82 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $645.65 Typical High $977.24 | Professional | 54 · Surgery only | $575.44 | $645.65 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $194.98 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $131.83 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $912.01 |
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· 28th of 51
$1,047
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.