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 $1,621.81 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,621.81 | $1,949.84 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
HMSA Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,090.30 | Professional | None | $2,398.83 | $2,818.38 | $3,090.30 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $1,202.26 Median $1,412.54 Typical High $1,548.82 | Professional | 51 · Multiple procedures | $1,202.26 | $1,412.54 | $1,548.82 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $478.63 Typical High $524.81 | Professional | AS · PA/NP assist | $407.38 | $478.63 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,862.09 | $2,238.72 | $2,818.38 |
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 $2,454.71 Median $2,454.71 Typical High $2,511.89 | Professional | None | $2,454.71 | $2,454.71 | $2,511.89 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $1,778.28 Typical High $2,630.27 | Professional | None | $29.51 | $1,778.28 | $2,630.27 |
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 $812.83 Median $977.24 Typical High $1,513.56 | Professional | 52 · Reduced service | $812.83 | $977.24 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $398.11 Typical High $602.56 | Professional | 53 · Discontinued | $323.59 | $398.11 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,479.11 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,230.27 | $1,479.11 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $295.12 Typical High $457.09 | Professional | 55 · Aftercare only | $245.47 | $295.12 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $194.98 Typical High $302.00 | Professional | 56 · Pre-op care only | $162.18 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,380.38 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,380.38 | $2,137.96 |
Where Hawaii sits
The same service costs 5.0 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· 24th of 51
$2,455
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.