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 $776.25 Median $870.96 Typical High $1,380.38 | Professional | None | $776.25 | $870.96 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
HMSA Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,230.27 | $1,380.38 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $616.60 Typical High $676.08 | Professional | 51 · Multiple procedures | $524.81 | $616.60 | $676.08 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $213.80 Typical High $234.42 | Professional | AS · PA/NP assist | $177.83 | $213.80 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,202.26 | Professional | None | $812.83 | $954.99 | $1,202.26 |
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 $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | None | $1,047.13 | $1,047.13 | $1,096.48 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $147.91 Typical High $1,174.90 | Professional | None | $29.51 | $147.91 | $1,174.90 |
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 $389.05 Median $436.52 Typical High $676.08 | Professional | 52 · Reduced service | $389.05 | $436.52 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $173.78 Typical High $269.15 | Professional | 53 · Discontinued | $154.88 | $173.78 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $1,023.29 | Professional | 54 · Surgery only | $588.84 | $645.65 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $204.17 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $87.10 Typical High $134.90 | Professional | 56 · Pre-op care only | $77.62 | $87.10 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $954.99 |
Where Hawaii sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 31st of 51
$1,047
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.