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 $2,570.40 Median $6,025.60 Typical High $6,025.60 | Facility | None | $2,570.40 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,380.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,513.56 | $1,905.46 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $5,754.40 | Facility | None | $3,019.95 | $3,548.13 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,659.59 | $1,737.80 |
University Health Alliance Setting Professional Modifier None Typical Low $229.09 Median $1,819.70 Typical High $1,819.70 | Professional | None | $229.09 | $1,819.70 | $1,819.70 |
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 $616.60 Median $691.83 Typical High $1,071.52 | Professional | 52 · Reduced service | $616.60 | $691.83 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $275.42 Typical High $426.58 | Professional | 53 · Discontinued | $245.47 | $275.42 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,584.89 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $208.93 Typical High $323.59 | Professional | 55 · Aftercare only | $181.97 | $208.93 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $138.04 Typical High $213.80 | Professional | 56 · Pre-op care only | $123.03 | $138.04 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $954.99 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $851.14 | $954.99 | $1,479.11 |
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· 30th of 51
$1,660
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.