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 $891.25 Median $1,023.29 Typical High $1,513.56 | Professional | None | $891.25 | $1,023.29 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
HMSA Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,479.11 | $1,621.81 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $741.31 Typical High $812.83 | Professional | 51 · Multiple procedures | $630.96 | $741.31 | $812.83 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $251.19 Typical High $275.42 | Professional | AS · PA/NP assist | $213.80 | $251.19 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,202.26 | $1,479.11 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $173.78 Typical High $1,380.38 | Professional | None | $29.51 | $173.78 | $1,380.38 |
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 $446.68 Median $512.86 Typical High $758.58 | Professional | 52 · Reduced service | $446.68 | $512.86 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $204.17 Typical High $302.00 | Professional | 53 · Discontinued | $177.83 | $204.17 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $1,148.15 | Professional | 54 · Surgery only | $676.08 | $758.58 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $229.09 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $102.33 Typical High $151.36 | Professional | 56 · Pre-op care only | $89.13 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $1,071.52 |
Where Hawaii sits
The same service costs 4.9 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· 26th of 51
$1,259
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.