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 $1,202.26 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,348.96 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
HMSA Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,905.46 | $2,089.30 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $954.99 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $812.83 | $954.99 | $1,047.13 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $323.59 Typical High $354.81 | Professional | AS · PA/NP assist | $275.42 | $323.59 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,479.11 | $1,819.70 |
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 $1,621.81 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,621.81 | $1,621.81 | $1,659.59 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $223.87 Typical High $1,778.28 | Professional | None | $29.51 | $223.87 | $1,778.28 |
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 $588.84 Median $660.69 Typical High $1,023.29 | Professional | 52 · Reduced service | $588.84 | $660.69 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $269.15 Typical High $416.87 | Professional | 53 · Discontinued | $239.88 | $269.15 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,000.00 Typical High $1,548.82 | Professional | 54 · Surgery only | $891.25 | $1,000.00 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $199.53 Typical High $309.03 | Professional | 55 · Aftercare only | $177.83 | $199.53 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $134.90 Typical High $208.93 | Professional | 56 · Pre-op care only | $117.49 | $134.90 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $933.25 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $831.76 | $933.25 | $1,445.44 |
Where Hawaii sits
The same service costs 6.5 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· 30th of 51
$1,622
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.