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 $1,698.24 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,698.24 | $1,905.46 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
HMSA Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,691.53 | $2,951.21 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,348.96 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $1,148.15 | $1,348.96 | $1,479.11 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $457.09 Typical High $501.19 | Professional | AS · PA/NP assist | $389.05 | $457.09 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,698.24 | $2,041.74 | $2,570.40 |
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 $2,290.87 Median $2,290.87 Typical High $2,344.23 | Professional | None | $2,290.87 | $2,290.87 | $2,344.23 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $316.23 Typical High $2,511.89 | Professional | None | $29.51 | $316.23 | $2,511.89 |
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 $851.14 Median $954.99 Typical High $1,445.44 | Professional | 52 · Reduced service | $851.14 | $954.99 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $588.84 | Professional | 53 · Discontinued | $338.84 | $380.19 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,412.54 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,288.25 | $1,412.54 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $436.52 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $190.55 Typical High $295.12 | Professional | 56 · Pre-op care only | $169.82 | $190.55 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,318.26 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,318.26 | $2,041.74 |
Where Hawaii sits
The same service costs 5.5 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
$2,291
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.