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 $1,513.56 Median $3,890.45 Typical High $3,890.45 | Facility | None | $1,513.56 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,445.44 | Professional | None | $831.76 | $933.25 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,348.96 | Professional | None | $891.25 | $1,071.52 | $1,348.96 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $3,890.45 | Facility | None | $2,238.72 | $3,019.95 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,174.90 | Professional | None | $1,148.15 | $1,148.15 | $1,174.90 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $158.49 Typical High $1,258.93 | Professional | None | $29.51 | $158.49 | $1,258.93 |
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 $416.87 Median $467.74 Typical High $707.95 | Professional | 52 · Reduced service | $416.87 | $467.74 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $288.40 | Professional | 53 · Discontinued | $165.96 | $186.21 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $707.95 Typical High $1,071.52 | Professional | 54 · Surgery only | $630.96 | $707.95 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $141.25 Typical High $213.80 | Professional | 55 · Aftercare only | $125.89 | $141.25 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $93.33 Typical High $141.25 | Professional | 56 · Pre-op care only | $83.18 | $93.33 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $660.69 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $588.84 | $660.69 | $1,000.00 |
Where Hawaii sits
The same service costs 5.8 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· 29th of 51
$1,148
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.