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 $954.99 Median $1,071.52 Typical High $1,659.59 | Professional | None | $954.99 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
HMSA Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,513.56 | $1,659.59 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $758.58 Typical High $831.76 | Professional | 51 · Multiple procedures | $645.65 | $758.58 | $831.76 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $257.04 Typical High $281.84 | Professional | AS · PA/NP assist | $218.78 | $257.04 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,445.44 | Professional | None | $977.24 | $1,174.90 | $1,445.44 |
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 $1,288.25 Median $1,288.25 Typical High $1,318.26 | Professional | None | $1,288.25 | $1,288.25 | $1,318.26 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $177.83 Typical High $1,412.54 | Professional | None | $29.51 | $177.83 | $1,412.54 |
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 $478.63 Median $537.03 Typical High $831.76 | Professional | 52 · Reduced service | $478.63 | $537.03 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $213.80 Typical High $331.13 | Professional | 53 · Discontinued | $190.55 | $213.80 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $794.33 Typical High $1,258.93 | Professional | 54 · Surgery only | $707.95 | $794.33 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $251.19 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $107.15 Typical High $165.96 | Professional | 56 · Pre-op care only | $95.50 | $107.15 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $1,174.90 |
Where Hawaii sits
The same service costs 5.9 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· 27th of 51
$1,288
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.