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 $1,122.02 Typical High $1,698.24 | Professional | None | $954.99 | $1,122.02 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
HMSA Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,584.89 | $1,737.80 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $794.33 Typical High $870.96 | Professional | 51 · Multiple procedures | $676.08 | $794.33 | $870.96 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $295.12 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,230.27 | $1,548.82 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $7,079.46 | Facility | None | $3,090.30 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,380.38 | Professional | None | $1,348.96 | $1,348.96 | $1,380.38 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $186.21 Typical High $1,479.11 | Professional | None | $29.51 | $186.21 | $1,479.11 |
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 $501.19 Median $549.54 Typical High $851.14 | Professional | 52 · Reduced service | $501.19 | $549.54 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $223.87 Typical High $338.84 | Professional | 53 · Discontinued | $199.53 | $223.87 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $1,258.93 | Professional | 54 · Surgery only | $758.58 | $831.76 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $251.19 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $169.82 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $1,174.90 |
Where Hawaii sits
The same service costs 6.0 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
$1,349
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.