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 $1,949.84 Median $5,495.41 Typical High $5,495.41 | Facility | None | $1,949.84 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,258.93 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,380.38 | $1,698.24 |
United Setting Facility Modifier None Typical Low $3,467.37 Median $3,981.07 Typical High $10,232.93 | Facility | None | $3,467.37 | $3,981.07 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,513.56 | $1,584.89 |
University Health Alliance Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,479.11 | $1,659.59 | $1,659.59 |
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 $549.54 Median $616.60 Typical High $954.99 | Professional | 52 · Reduced service | $549.54 | $616.60 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $389.05 | Professional | 53 · Discontinued | $223.87 | $245.47 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $831.76 | $933.25 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $288.40 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $194.98 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $1,348.96 |
Where Hawaii sits
The same service costs 25.7 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· 28th of 51
$1,514
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.