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 $128.82 Median $223.87 Typical High $416.87 | Professional | None | $128.82 | $223.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $416.87 | Professional | None | $302.00 | $416.87 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $489.78 | Professional | None | $229.09 | $398.11 | $489.78 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,148.15 | Facility | None | $794.33 | $1,047.13 | $1,148.15 |
United Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $416.87 | Professional | None | $229.09 | $416.87 | $416.87 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $263.03 Typical High $467.74 | Professional | None | $29.51 | $263.03 | $467.74 |
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 $64.57 Median $109.65 Typical High $181.97 | Professional | 52 · Reduced service | $64.57 | $109.65 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $43.65 Typical High $74.13 | Professional | 53 · Discontinued | $25.70 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $165.96 Typical High $275.42 | Professional | 54 · Surgery only | $97.72 | $165.96 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $33.11 Typical High $54.95 | Professional | 55 · Aftercare only | $19.50 | $33.11 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $21.88 Typical High $36.31 | Professional | 56 · Pre-op care only | $12.88 | $21.88 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $154.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $91.20 | $154.88 | $257.04 |
Where Hawaii sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 16th of 51
$339
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.