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 $3,467.37 Median $4,168.69 Typical High $6,606.93 | Professional | None | $3,467.37 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
HMSA Setting Professional Modifier None Typical Low $5,011.87 Median $5,888.44 Typical High $6,456.54 | Professional | None | $5,011.87 | $5,888.44 | $6,456.54 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $2,511.89 Median $2,951.21 Typical High $3,235.94 | Professional | 51 · Multiple procedures | $2,511.89 | $2,951.21 | $3,235.94 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $851.14 Median $1,000.00 Typical High $1,096.48 | Professional | AS · PA/NP assist | $851.14 | $1,000.00 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,801.89 Median $4,570.88 Typical High $5,754.40 | Professional | None | $3,801.89 | $4,570.88 | $5,754.40 |
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 $5,011.87 Median $5,011.87 Typical High $5,248.07 | Professional | None | $5,011.87 | $5,011.87 | $5,248.07 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $3,715.35 Typical High $5,495.41 | Professional | None | $29.51 | $3,715.35 | $5,495.41 |
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 $1,737.80 Median $2,089.30 Typical High $3,311.31 | Professional | 52 · Reduced service | $1,737.80 | $2,089.30 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $831.76 Typical High $1,318.26 | Professional | 53 · Discontinued | $691.83 | $831.76 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $3,090.30 Typical High $4,897.79 | Professional | 54 · Surgery only | $2,630.27 | $3,090.30 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $630.96 Typical High $977.24 | Professional | 55 · Aftercare only | $524.81 | $630.96 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $416.87 Typical High $660.69 | Professional | 56 · Pre-op care only | $346.74 | $416.87 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,884.03 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,884.03 | $4,570.88 |
Where Hawaii sits
The same service costs 21.9 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· 25th of 51
$5,012
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.