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 $2,187.76 Median $2,454.71 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,454.71 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
HMSA Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $3,801.89 | Professional | None | $2,951.21 | $3,467.37 | $3,801.89 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $1,479.11 Median $1,737.80 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $1,479.11 | $1,737.80 | $1,905.46 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $501.19 Median $588.84 Typical High $645.65 | Professional | AS · PA/NP assist | $501.19 | $588.84 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $3,311.31 | Professional | None | $2,187.76 | $2,630.27 | $3,311.31 |
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 $2,951.21 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,951.21 | $2,951.21 | $3,090.30 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $407.38 Typical High $3,235.94 | Professional | None | $29.51 | $407.38 | $3,235.94 |
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 $1,071.52 Median $1,202.26 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,071.52 | $1,202.26 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $489.78 Typical High $758.58 | Professional | 53 · Discontinued | $436.52 | $489.78 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,819.70 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,621.81 | $1,819.70 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $363.08 Typical High $575.44 | Professional | 55 · Aftercare only | $323.59 | $363.08 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $245.47 Typical High $380.19 | Professional | 56 · Pre-op care only | $218.78 | $245.47 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,698.24 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,698.24 | $2,691.53 |
Where Hawaii sits
The same service costs 21.4 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· 28th of 51
$2,951
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.