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 $8,511.38 Typical High $8,511.38 | Facility | None | $2,818.38 | $8,511.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,202.26 | Professional | None | $691.83 | $776.25 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
HMSA Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,202.26 | Professional | None | $933.25 | $1,096.48 | $1,202.26 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $549.54 Typical High $602.56 | Professional | 51 · Multiple procedures | $467.74 | $549.54 | $602.56 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $204.17 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,071.52 | Professional | None | $724.44 | $870.96 | $1,071.52 |
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 $933.25 Median $933.25 Typical High $977.24 | Professional | None | $933.25 | $933.25 | $977.24 |
University Health Alliance Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | None | $933.25 | $1,023.29 | $1,023.29 |
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 $346.74 Median $389.05 Typical High $602.56 | Professional | 52 · Reduced service | $346.74 | $389.05 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $239.88 | Professional | 53 · Discontinued | $138.04 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $891.25 | Professional | 54 · Surgery only | $512.86 | $575.44 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $177.83 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $120.23 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $831.76 |
Where Hawaii sits
The same service costs 5.9 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· 27th of 51
$1,000
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.