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 $933.25 Median $2,818.38 Typical High $3,890.45 | Facility | None | $933.25 | $2,818.38 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $870.96 | Professional | None | $478.63 | $575.44 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,584.89 | Facility | None | $977.24 | $1,096.48 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $870.96 | Professional | None | $575.44 | $691.83 | $870.96 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $2,570.40 | Facility | None | $2,041.74 | $2,511.89 | $2,570.40 |
United Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $97.72 Typical High $776.25 | Professional | None | $29.51 | $97.72 | $776.25 |
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 $234.42 Median $281.84 Typical High $426.58 | Professional | 52 · Reduced service | $234.42 | $281.84 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $169.82 | Professional | 53 · Discontinued | $95.50 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $426.58 Typical High $630.96 | Professional | 54 · Surgery only | $354.81 | $426.58 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $128.82 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $85.11 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $398.11 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $331.13 | $398.11 | $588.84 |
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· 27th of 51
$708
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.