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 $831.76 Median $933.25 Typical High $1,348.96 | Professional | None | $831.76 | $933.25 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
HMSA Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,318.26 | $1,445.44 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $660.69 Typical High $724.44 | Professional | 51 · Multiple procedures | $562.34 | $660.69 | $724.44 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $245.47 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,288.25 | Professional | None | $851.14 | $1,023.29 | $1,288.25 |
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 $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,122.02 | $1,174.90 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $154.88 Typical High $1,230.27 | Professional | None | $29.51 | $154.88 | $1,230.27 |
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 $416.87 Median $467.74 Typical High $724.44 | Professional | 52 · Reduced service | $416.87 | $467.74 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $288.40 | Professional | 53 · Discontinued | $165.96 | $186.21 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $691.83 Typical High $1,071.52 | Professional | 54 · Surgery only | $616.60 | $691.83 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $141.25 Typical High $218.78 | Professional | 55 · Aftercare only | $125.89 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $93.33 Typical High $144.54 | Professional | 56 · Pre-op care only | $83.18 | $93.33 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $645.65 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $575.44 | $645.65 | $1,000.00 |
Where Hawaii sits
The same service costs 7.4 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· 31st of 51
$1,122
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.