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 $1,258.93 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,412.54 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
HMSA Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,187.76 | Professional | None | $1,698.24 | $1,995.26 | $2,187.76 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $1,000.00 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $851.14 | $1,000.00 | $1,096.48 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $338.84 Typical High $371.54 | Professional | AS · PA/NP assist | $288.40 | $338.84 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,548.82 | $1,949.84 |
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 $1,698.24 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,698.24 | $1,698.24 | $1,778.28 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $234.42 Typical High $1,862.09 | Professional | None | $29.51 | $234.42 | $1,862.09 |
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 $1,096.48 | Professional | 52 · Reduced service | $616.60 | $691.83 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $281.84 Typical High $436.52 | Professional | 53 · Discontinued | $251.19 | $281.84 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,659.59 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $331.13 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $141.25 Typical High $218.78 | Professional | 56 · Pre-op care only | $125.89 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,548.82 |
Where Hawaii sits
The same service costs 5.2 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
$1,698
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.