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 $794.33 Median $870.96 Typical High $1,348.96 | Professional | None | $794.33 | $870.96 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,230.27 | Professional | None | $831.76 | $1,000.00 | $1,230.27 |
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 $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | None | $1,071.52 | $1,071.52 | $1,122.02 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $776.25 Typical High $1,174.90 | Professional | None | $29.51 | $776.25 | $1,174.90 |
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 $398.11 Median $436.52 Typical High $676.08 | Professional | 52 · Reduced service | $398.11 | $436.52 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $177.83 Typical High $269.15 | Professional | 53 · Discontinued | $158.49 | $177.83 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $1,023.29 | Professional | 54 · Surgery only | $588.84 | $660.69 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $204.17 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $134.90 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $954.99 |
Where Hawaii sits
The same service costs 5.0 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
$1,072
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.