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 $977.24 Median $1,096.48 Typical High $1,698.24 | Professional | None | $977.24 | $1,096.48 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
HMSA Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,548.82 | $1,698.24 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $776.25 Typical High $851.14 | Professional | 51 · Multiple procedures | $660.69 | $776.25 | $851.14 |
HMSA Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $263.03 Typical High $288.40 | Professional | AS · PA/NP assist | $223.87 | $263.03 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,202.26 | $1,513.56 |
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 $1,318.26 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,318.26 | $1,380.38 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $954.99 Typical High $1,445.44 | Professional | None | $29.51 | $954.99 | $1,445.44 |
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 $489.78 Median $549.54 Typical High $851.14 | Professional | 52 · Reduced service | $489.78 | $549.54 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $218.78 Typical High $338.84 | Professional | 53 · Discontinued | $194.98 | $218.78 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $1,258.93 | Professional | 54 · Surgery only | $724.44 | $812.83 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $162.18 Typical High $251.19 | Professional | 55 · Aftercare only | $144.54 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $169.82 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $1,174.90 |
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· 30th of 51
$1,318
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.