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 $3,162.28 Median $3,548.13 Typical High $5,495.41 | Professional | None | $3,162.28 | $3,548.13 | $5,495.41 |
HMSA Setting Professional Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $5,495.41 | Professional | None | $4,265.80 | $5,011.87 | $5,495.41 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $2,137.96 Median $2,511.89 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $2,137.96 | $2,511.89 | $2,754.23 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $724.44 Median $851.14 Typical High $933.25 | Professional | AS · PA/NP assist | $724.44 | $851.14 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $4,897.79 | Professional | None | $3,235.94 | $3,890.45 | $4,897.79 |
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 $4,265.80 Median $4,265.80 Typical High $4,466.84 | Professional | None | $4,265.80 | $4,265.80 | $4,466.84 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $3,162.28 Typical High $4,677.35 | Professional | None | $29.51 | $3,162.28 | $4,677.35 |
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 $1,584.89 Median $1,778.28 Typical High $2,754.23 | Professional | 52 · Reduced service | $1,584.89 | $1,778.28 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $707.95 Typical High $1,096.48 | Professional | 53 · Discontinued | $630.96 | $707.95 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,630.27 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,344.23 | $2,630.27 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $524.81 Typical High $831.76 | Professional | 55 · Aftercare only | $467.74 | $524.81 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $354.81 Typical High $549.54 | Professional | 56 · Pre-op care only | $316.23 | $354.81 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,454.71 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,454.71 | $3,890.45 |
Where Hawaii sits
The same service costs 27.5 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
$4,571
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.