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 $2,454.71 Median $2,754.23 Typical High $4,168.69 | Professional | None | $2,454.71 | $2,754.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
HMSA Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $4,265.80 | Professional | None | $3,311.31 | $3,890.45 | $4,265.80 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $1,659.59 Median $1,949.84 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $1,659.59 | $1,949.84 | $2,137.96 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $562.34 Median $660.69 Typical High $724.44 | Professional | AS · PA/NP assist | $562.34 | $660.69 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,454.71 | $2,951.21 | $3,715.35 |
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 $3,311.31 Median $3,311.31 Typical High $3,388.44 | Professional | None | $3,311.31 | $3,311.31 | $3,388.44 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $457.09 Typical High $3,630.78 | Professional | None | $29.51 | $457.09 | $3,630.78 |
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 $1,230.27 Median $1,348.96 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,230.27 | $1,348.96 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $549.54 Typical High $851.14 | Professional | 53 · Discontinued | $489.78 | $549.54 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,041.74 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,862.09 | $2,041.74 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $407.38 Typical High $630.96 | Professional | 55 · Aftercare only | $371.54 | $407.38 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $269.15 Typical High $416.87 | Professional | 56 · Pre-op care only | $245.47 | $269.15 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,905.46 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,905.46 | $2,951.21 |
Where Hawaii sits
The same service costs 22.4 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
$3,311
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.