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 $1,000.00 Median $2,884.03 Typical High $2,884.03 | Facility | None | $1,000.00 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $338.84 | Professional | None | $128.82 | $218.78 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $323.59 | Professional | None | $269.15 | $323.59 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $363.08 | Professional | None | $151.36 | $295.12 | $363.08 |
United Setting Facility Modifier None Typical Low $269.15 Median $616.60 Typical High $1,122.02 | Facility | None | $269.15 | $616.60 | $1,122.02 |
United Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $323.59 | Professional | None | $177.83 | $323.59 | $323.59 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $186.21 Typical High $338.84 | Professional | None | $29.51 | $186.21 | $338.84 |
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 $102.33 Typical High $144.54 | Professional | 52 · Reduced service | $64.57 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $57.54 | Professional | 53 · Discontinued | $25.70 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $154.88 Typical High $213.80 | Professional | 54 · Surgery only | $95.50 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $30.90 Typical High $42.66 | Professional | 55 · Aftercare only | $19.05 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.42 Typical High $28.84 | Professional | 56 · Pre-op care only | $12.88 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $144.54 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $89.13 | $144.54 | $199.53 |
Where Hawaii sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 20th of 51
$263
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.