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 $1,380.38 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,548.82 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
HMSA Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,398.83 | Professional | None | $1,862.09 | $2,187.76 | $2,398.83 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,096.48 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $933.25 | $1,096.48 | $1,202.26 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $371.54 Typical High $407.38 | Professional | AS · PA/NP assist | $316.23 | $371.54 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,698.24 | $2,137.96 |
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 $1,862.09 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,862.09 | $1,862.09 | $1,949.84 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $1,380.38 Typical High $2,041.74 | Professional | None | $29.51 | $1,380.38 | $2,041.74 |
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 $691.83 Median $776.25 Typical High $1,202.26 | Professional | 52 · Reduced service | $691.83 | $776.25 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $309.03 Typical High $478.63 | Professional | 53 · Discontinued | $275.42 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,174.90 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,023.29 | $1,174.90 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $234.42 Typical High $363.08 | Professional | 55 · Aftercare only | $204.17 | $234.42 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $154.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $138.04 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,096.48 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $954.99 | $1,096.48 | $1,698.24 |
Where Hawaii sits
The same service costs 21.9 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· 28th of 51
$1,862
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.