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 $1,548.82 Median $1,737.80 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
HMSA Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,691.53 | Professional | None | $2,089.30 | $2,454.71 | $2,691.53 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,230.27 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $1,047.13 | $1,230.27 | $1,348.96 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $416.87 Typical High $457.09 | Professional | AS · PA/NP assist | $354.81 | $416.87 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,862.09 | $2,344.23 |
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 $2,089.30 Median $2,089.30 Typical High $2,137.96 | Professional | None | $2,089.30 | $2,089.30 | $2,137.96 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $288.40 Typical High $2,290.87 | Professional | None | $29.51 | $288.40 | $2,290.87 |
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 $776.25 Median $870.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $776.25 | $870.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $346.74 Typical High $537.03 | Professional | 53 · Discontinued | $309.03 | $346.74 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,288.25 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,148.15 | $1,288.25 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $263.03 Typical High $398.11 | Professional | 55 · Aftercare only | $229.09 | $263.03 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $173.78 Typical High $269.15 | Professional | 56 · Pre-op care only | $154.88 | $173.78 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,202.26 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,202.26 | $1,862.09 |
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· 29th of 51
$2,089
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.