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 $562.34 Median $676.08 Typical High $1,000.00 | Professional | None | $562.34 | $676.08 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,000.00 | Professional | None | $676.08 | $794.33 | $1,000.00 |
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 $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $616.60 Typical High $912.01 | Professional | None | $29.51 | $616.60 | $912.01 |
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 $281.84 Median $331.13 Typical High $501.19 | Professional | 52 · Reduced service | $281.84 | $331.13 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $199.53 | Professional | 53 · Discontinued | $112.20 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $758.58 | Professional | 54 · Surgery only | $416.87 | $501.19 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $151.36 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $100.00 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $467.74 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $389.05 | $467.74 | $707.95 |
Where Hawaii sits
The same service costs 5.4 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
$832
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.