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 $1,513.56 Median $3,890.45 Typical High $3,890.45 | Facility | None | $1,513.56 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $562.34 | Professional | None | $218.78 | $323.59 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $446.68 | Professional | None | $416.87 | $446.68 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $549.54 | Professional | None | $371.54 | $446.68 | $549.54 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $2,570.40 | Facility | None | $2,041.74 | $2,511.89 | $2,570.40 |
United Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | None | $363.08 | $446.68 | $446.68 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $316.23 Typical High $478.63 | Professional | None | $29.51 | $316.23 | $478.63 |
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 $104.71 Median $158.49 Typical High $239.88 | Professional | 52 · Reduced service | $104.71 | $158.49 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $63.10 Typical High $97.72 | Professional | 53 · Discontinued | $41.69 | $63.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $239.88 Typical High $363.08 | Professional | 54 · Surgery only | $158.49 | $239.88 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $47.86 Typical High $72.44 | Professional | 55 · Aftercare only | $31.62 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $31.62 Typical High $48.98 | Professional | 56 · Pre-op care only | $20.89 | $31.62 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $147.91 | $223.87 | $338.84 |
Where Hawaii sits
The same service costs 4.6 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· 19th of 51
$427
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.