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 $4,168.69 Median $4,677.35 Typical High $7,244.36 | Professional | None | $4,168.69 | $4,677.35 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
HMSA Setting Professional Modifier None Typical Low $5,623.41 Median $6,606.93 Typical High $7,244.36 | Professional | None | $5,623.41 | $6,606.93 | $7,244.36 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $2,818.38 Median $3,311.31 Typical High $3,630.78 | Professional | 51 · Multiple procedures | $2,818.38 | $3,311.31 | $3,630.78 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $954.99 Median $1,122.02 Typical High $1,230.27 | Professional | AS · PA/NP assist | $954.99 | $1,122.02 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,265.80 Median $5,128.61 Typical High $6,309.57 | Professional | None | $4,265.80 | $5,128.61 | $6,309.57 |
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 $5,623.41 Median $5,623.41 Typical High $5,888.44 | Professional | None | $5,623.41 | $5,623.41 | $5,888.44 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $4,073.80 Typical High $6,165.95 | Professional | None | $29.51 | $4,073.80 | $6,165.95 |
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 $2,089.30 Median $2,344.23 Typical High $3,630.78 | Professional | 52 · Reduced service | $2,089.30 | $2,344.23 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $933.25 Typical High $1,479.11 | Professional | 53 · Discontinued | $831.76 | $933.25 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,467.37 Typical High $5,495.41 | Professional | 54 · Surgery only | $3,090.30 | $3,467.37 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $691.83 Typical High $1,096.48 | Professional | 55 · Aftercare only | $616.60 | $691.83 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $467.74 Typical High $724.44 | Professional | 56 · Pre-op care only | $416.87 | $467.74 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,235.94 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,235.94 | $5,128.61 |
Where Hawaii sits
The same service costs 20.4 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· 29th of 51
$5,623
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.