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 $1,047.13 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,258.93 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
HMSA Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,819.70 | $1,995.26 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $912.01 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $776.25 | $912.01 | $1,000.00 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $309.03 Typical High $338.84 | Professional | AS · PA/NP assist | $263.03 | $309.03 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,412.54 | $1,778.28 |
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 $1,548.82 Median $1,548.82 Typical High $1,584.89 | Professional | None | $1,548.82 | $1,548.82 | $1,584.89 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $213.80 Typical High $1,698.24 | Professional | None | $29.51 | $213.80 | $1,698.24 |
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 $524.81 Median $630.96 Typical High $977.24 | Professional | 52 · Reduced service | $524.81 | $630.96 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $251.19 Typical High $389.05 | Professional | 53 · Discontinued | $208.93 | $251.19 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $954.99 Typical High $1,479.11 | Professional | 54 · Surgery only | $794.33 | $954.99 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $295.12 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $125.89 Typical High $194.98 | Professional | 56 · Pre-op care only | $104.71 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $891.25 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $741.31 | $891.25 | $1,380.38 |
Where Hawaii sits
The same service costs 20.9 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· 26th of 51
$1,549
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.